核素扫描对红斑狼疮脑损害诊断的评价

Evaluation of radionuclide scanning used in the diagnosis of brain damage from systemic lupus erythematosus

目的 探讨狼疮脑和非狼疮脑患者脑血供的差别。方法 用单光子发射电子计算机扫描 (SPECT)观察脑血流的变化 ,选择脑感兴趣区及半定量计算非对称指数 (AI)法分析 ,狼疮脑患者同时行核磁共振 (MRI)检查。结果 2 0例狼疮脑 (Ⅰ组 )和 2 3例非狼疮脑 (Ⅱ组 )SPECT血流减少部位分别为 83处和 74处 (P >0 0 5 ) ;AI值Ⅰ、Ⅱ组分别为 6 85± 1 98和 6 45± 1 87(P >0 0 5 )。两组患者血流灌注不足的部位依次主要分布在额叶、顶叶和颞叶 ,其次是枕叶和小脑。Ⅰ组中 14例MRI检查发现 87处病灶 ,同时有SPECT和MRI异常部位 5 1处 (占 81% ) ,其中 12例患者的神经精神症状至少和一处SPECT异常有关。

Objective To investigate difference of brain perfusion between neuropsychiatric and non neuropsychiatric lupus patients.Methods Blood flow changes of 43 lupus patients were observed by single photon emission computed tomography(SPECT) scanning.Some interested cerebral areas were selected and semi quantitative method to calculate asymmetric index(AI)for analysis was used.Cerebro lupus patients were examined with MRI.Results 83 hypoperfusion areas and 74 areas were found in 20 neuropsychiatric(group Ⅰ) and 23 non neuropsychiatric(group Ⅱ) patients respectively( P >0 05).AI values of SPECT were 6 85±1 98 in group Ⅰ and 6 45±1 87 in group Ⅱ( P >0 05).Hypoperfusion areas of both groups were mainly distributed in frontal,parietal and temporal lobes.In group Ⅰ,we found 14 patients with total 87 MRI lesions and 51 areas of both MRI and SPECT abnormalities.Neuropsychiatric symptoms of 12 cases had correlation with at least one hypoperfusion lobes.Conclusion SPECT is the most sensitive method for early evaluating brain damage of patients with lupus.