系统性红斑狼疮脑病患者的rCBF显像与CT/MRI的对比研究

Regional cerebral blood flow image and CT/MRI scan for neuropsychiatric in systemic lupus erythematosus patients: a comparative study

目的观察系统性红斑狼疮脑病(简称狼疮脑病)患者rCBF显像结果并与CT/MRI比较,探讨rCBF显像对狼疮脑病的临床应用价值。方法40例狼疮脑病患者根据神经精神表现程度分为两组:严重神经精神疾病表现组20例(严重组),轻度神经精神疾病表现组20例(轻度组)。所有受试对象均进行单光子发射计算机断层(SPECT)局部脑血流灌注(rCBF)显像和CT/MRI脑扫描。结果严重组20例患者rCBF显像阳性20例(100.0%),其中19例局部脑血流降低,1例局部脑血流增加;20例患者CT/MRI头部扫描阳性4例(20.0%),与rCBF显像相比有显著性差异(P<0.01)。轻度组20例患者rCBF显像阳性18例(90.0%),均表现为局部脑血流降低;CT/MRI扫描20例患者未见异常,同rCBF显像相比有显著性差异(P<0.01)。结论rCBF显像与CT/MRI比较,诊断狼疮脑病更灵敏。狼疮脑病患者rCBF显像有脑血流改变,多表现为局部脑血流降低。rCBF显像对狼疮脑病的诊断、治疗有重要临床价值。

Objective To compare the diagnostic value of regional cerebral blood flow （rCBF） and CT/MRI scan for neuropsychiatric in systemic lupus erythematosus （SLE） and evaluate rCBF SPECT imaging in the detection of neuropsychiatric in SLE patients. Methods Forty neuropsychiatric SLE patients were enrolled in the study and divided into 2 groups. Group 1 consisted of 20 patients with major neuropsychiatric manifestations （major）, group 2 consisted of 20 patients with minor neuropsychiatric manifestations （minor）. All neuropsychiatric SLE patients were performed SPECT rCBF imaging and CT/ MRI scans, respectively. Results Twenty patients with major neuropsychiatric manifestations had all abnormal SPECT findings. Nineteen of 20 patients with abnormal SPECT findings showed focal uptake defects; another patient showed focal uptake increase; 4 of 20 patients with major neuropsychiatric manifestations had abnormal CT/MRI scans findings. Eighteen of 20 patients with minor neuropsychiatric manifestations had abnormal SPECT findings, which all showed focal uptake defects and there were no abnormal finding in CT/MRI scans. Conclusion SPECT rCBF imaging represents a more sensitive tool than CT/MRI to detect the neuropsychiatric manifestations in SLE patients, the change of rCBF, especially, decreases in rCBF are associated with serious neuropsychiatric SLE presentations, rCBF is helpful for clinical diagnosis and therapy of SLE.