García-Burillo A, Castell J, Fraile M, Jacas C, Vilardell M, Ortega D, Bosch J A
Department of Nuclear Medicine, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
J Nucl Med. 1998 Jun;39(6):950-4.
Behçet's disease (BD) is an idiopathic multisystem disorder. Involvement of the central nervous system (CNS) occurs in 4%-48% of cases. The aim of this study was to evaluate 99mTc-hexamethyl propyleneamine oxime (HMPAO) SPECT findings in BD patients and eventually to detect CNS involvement by depicting cerebral blood flow disturbances.
Technetium-99m-HMPAO brain SPECT was performed on 33 consecutive BD patients. Qualitative and quantitative evaluation of the cortical uptake was done using an automatic program that generated 32 regions of interest (ROIs). An uptake index for each ROI was obtained. Reference values were obtained from a healthy control group (n = 20). Twenty-five patients also had an MRI study.
Twelve of 32 patients (36%) presented with a clinical neurological disorder. SPECT and visual evaluation revealed that 17 patients (51.5%) had abnormalities; 9 of 25 MRI studies (36%) were abnormal. Using the quantitative approach for SPECT, 23 patients (69.7%) had abnormally low values. Six of 12 patients with neurological symptoms had a visually abnormal SPECT scan, whereas quantitative analysis showed abnormalities in 11 patients. Of the 21 patients with no neurological findings, 9 had abnormal SPECT results, and 12 had low uptake indexes.
HMPAO brain SPECT shows high rates of cerebral blood flow abnormalities in BD patients presenting with neuropsychiatric symptoms, and it also is frequently abnormal in asymptomatic BD patients who have no abnormalities on MR scans. Compared with visual analysis, quantitative analysis detects an even higher rate of SPECT changes in BD patients.
白塞病（BD）是一种特发性多系统疾病。中枢神经系统（CNS）受累发生在4% - 48%的病例中。本研究的目的是评估BD患者的99mTc - 六甲基丙烯胺肟（HMPAO）单光子发射计算机断层扫描（SPECT）结果，并最终通过描绘脑血流紊乱来检测CNS受累情况。
对33例连续的BD患者进行了锝 - 99m - HMPAO脑SPECT检查。使用生成32个感兴趣区域（ROI）的自动程序对皮质摄取进行定性和定量评估。获得每个ROI的摄取指数。从健康对照组（n = 20）获得参考值。25例患者还进行了磁共振成像（MRI）研究。
32例患者中有12例（36%）出现临床神经功能障碍。SPECT和视觉评估显示17例患者（51.5%）有异常；25例MRI研究中有9例（36%）异常。使用SPECT的定量方法，23例患者（69.7%）的值异常低。12例有神经症状的患者中有6例SPECT扫描视觉上异常，而定量分析显示11例患者有异常。在21例无神经学发现的患者中，9例SPECT结果异常，12例摄取指数低。
HMPAO脑SPECT显示，有神经精神症状的BD患者脑血流异常发生率高，在MRI扫描无异常的无症状BD患者中也经常出现异常。与视觉分析相比，定量分析检测到BD患者SPECT变化的发生率更高。
