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Evaluation of Regional Cerebral Blood Flow with ^99mTc-HMPAO in Primary Antiphospholipid Antibody Syndrome

Department of Nuclear Medicine and Division of Rheumatology, Taichung Veterans General Hospital, Taichung
Department of Nuclear Medicine, Chi-Mei Foundation Hospital, Tainan
Department of Radiology, Jen-Ai Hospital, Taichung
Department of Nuclear Medicine, Chung-Shan Medical and Dental College and Hospital, Taichung
Department of Nuclear Medicine and School of Technology for Medical Sciences, Kaohsiung Medical College, Kaohsiung, Taiwan

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.

ABSTRACT

In this study, ^99mTc-hexamethyl pyropyleneamine oxime (HMPAO) SPECT was used to evaluate the regional cerebral blood flow (rCBF)of the brain in patients with primary antiphospholipid antibody syndrome (PAPS). Methods: Twenty-two women who were PAPS patients, aged 28–60 y, with mild neuropsychiatric manifestations and normal brain MRI findings were enrolled in this study. Brain HMPAO SPECT was performed to detect brain abnormalities. Meanwhile, serum anticardiolipin antibodies (ACA) and lupus anticoagulant (LA) were measured. Results: HMPAO SPECT revealed hypoperfusion lesions in 16 of 22 (73%) PAPS patients. Cerebral cortex and cerebellum were the most and the least commonly involved areas, respectively. Eighteen of 22 (82%) and 14 of 22 (64%) patients had positive ACA and positive LA, respectively. ACA and LA results were related to HMPAO SPECT findings. Conclusion: HMPAO SPECT is a sensitive tool for detecting brain abnormalities in PAPS patients with only mild neuropsychiatric manifestations and normal brain MRI findings.

Key Words: regional cerebral bloodflow • ^99mTc-hexamethyl propyleneamine oxime • antiphospholipid antibody syndrome

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