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Abnormal regional cerebral blood flow on 99mTc ECD brain SPECT in patients with primary Sjögren's syndrome and normal findings on brain magnetic resonance imaging
  1. C P Chang1,
  2. Y C Shiau2,
  3. J J Wang3,
  4. S T Ho4,
  5. A Kao5
  1. 1Division of Allergy, Immunology, and Rheumatology, Changhua Christian Hospital, Changhua; Taiwan
  2. 2Department of Nuclear Medicine, Far Eastern Memorial Hospital, and Institute of Biomedical Engineering, College of Electrical Engineering, National Taiwan University, Taipei, Taiwan
  3. 3Department of Medical Research, Chi-Mei Medical Centre, Taiwan
  4. 4School of Medicine, National Defence Medical Centre, Taipei, Taiwan
  5. 5Departments of Nuclear Medicine and Medical Research, China Medicine College Hospital, Taichung; Taiwan

  1. Correspondence to:
    Dr A Kao, Departments of Nuclear Medicine and Medical Research, China Medical College Hospital, No 2 Yuh-Der Road, Taichung 404, Taiwan; albertkaotw{at}yahoo.com.tw.

Abstract

Objective: Technetium-99m ethyl cysteinate dimer (99mTc ECD) single photon emission computed tomography (SPECT) of the brain was used to detect abnormal regional cerebral blood flow (rCBF) in patients with primary Sjögren's syndrome (pSS) and normal findings on brain magnetic resonance imaging (MRI).

Methods:99mTc ECD brain SPECT was performed to detect brain lesions showing hypoperfusion in 32 female patients with pSS and definite neuropsychiatric symptoms or signs. Seventeen female patients with pSS without neuropsychiatric symptoms and signs were included as a control group for comparison. All of the 49 patients with pSS had normal findings on brain MRI.

Results:99mTc ECD brain SPECT showed brain regions with hypoperfusion in 18 (56.3%) of the 32 patients, and parietal lobes were the most common areas with such lesions. By contrast, 99mTc ECD brain SPECT showed brain regions with hypoperfusion in only three (17.6%) of the 17 patients with pSS without neuropsychiatric symptoms or signs.

Conclusion: This study suggests that 99mTc ECD SPECT is a sensitive tool for detecting regions of hypoperfusion in the brains of patients with pSS and neuropsychiatric symptoms or signs and normal findings on brain MRI. However, a review of the literature showed that the 99mTc ECD SPECT findings in patients with pSS were non-specific.

  • technetium-99m ethyl cysteinate dimer
  • single photon emission computed tomography
  • Sjögren's syndrome
  • MRI, magnetic resonance imaging
  • PET, positron emission tomography
  • pSS, primary Sjögren's syndrome
  • rCBF, regional cerebral blood flow
  • SLE, systemic lupus erythematosus
  • SPECT, single photon emission computed tomography
  • 99mTc ECD, technetium-99m ethyl cysteinate dimer
  • 99mTc HMPAO
  • technetium-99m hexamethylpropylene amine oxime

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