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Technetium-99m-HMPAO SPECT and MRI of Brain in Patients with Neuro-Behçet's Syndrome

Departments of Nuclear and Internal Medicine, Taichung Veterans General Hospital, Taichung; Department of Nuclear Medicine, Chung-Shan Medical College and Dental Hospital, Taipei, Taiwan; Department of Nuclear Medicine, National Taiwan University Hospital,, Taiwan, Republic of China

Correspondence: For correspondence or reprints contact:Chia-Hung Kao, MD, Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Taichung Harbor Rd., Section 3, Taichung 40705, Taiwan, Republic of China.

ABSTRACT

Involvement of the brain is one of the most important complications of Behçet's disease (BS). It is difficult to diagnose, however, because of the lack of effective imaging methods. Methods:Thirteen BS patients with neuropsychiatric symptoms or signs [Neuro-Behçet's syndrome (NBS)] were included in this study. We combined two routine brain imaging modalities—brain SPECT with ⁹⁹Tc-hexamethyl propyleneamine oxime (HMPAO) and brain MRI—with clinical manifestations to diagnose brain involvement. Results: Technetium-99m-HMPAO brain SPECT findings were abnormal fcin 100% (13/13) of patients. Brain MRI findings were abnormal in 31% (4/13) of patients. Gray matter was involved more commonly than white matter. In the gray matter, the cerebral cortex was the most commonly involved area and the cerebellum was the least commonly involved area in NBS. Conclusion: SPECT is a more sensitive and useful tool in detecting brain involvement in NBS patients compared with brain MRI. The combination of HMPAO and MRI is necessary to detect brain lesions in both gray and white matter in NBS.

Key Words: MRI • SPECT • Behçet's syndrome

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