technetium-tc-99m-exametazime and Antiphospholipid-Syndrome

Technetium-99m hexamethylpropylene amine oxime ((99m)Tc HMPAO) brain single photon emission computed tomography (SPECT) was used to evaluate the effects of anticoagulant therapy (ACT) on regional cerebral blood flow (rCBF) in patients with primary antiphospholipid antibody syndrome (PAPS). Sixteen female PAPS patients with neuropsychiatric manifestations and hypoperfusion lesions demonstrated on initial (99m)Tc HMPAO brain SPECT images were enrolled in this study. Follow-up (99m)Tc HMPAO brain SPECT images were performed 1 month after ACT. Meanwhile, serum anticardiolipin antibodies (ACA) were measured before and after ACT. Before ACT, 14 (87.5%) patients had positive ACA. After ACT, all 16 PAPS patients showed decreased serologic findings, and their neuropsychiatric manifestations subsided. After ACT, 11 (68.8%) patients showed complete recovery of regional cerebral blood flow (rCBF) and five (31.2%) patients showed partial recovery in the follow-up (99m)Tc HMPAO brain SPECT images. This type of imaging is a logical and objective tool for measuring the effects of ACT in PAPS patients with brain involvement by determining changes in rCBF.

Topics: Adult; Anticoagulants; Antiphospholipid Syndrome; Brain; Cerebrovascular Circulation; Female; Humans; Middle Aged; Neurocognitive Disorders; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Warfarin

Several clinical conditions, such as deep vein thrombosis, cerebral infarct, pulmonary infarct, skin ulcers, renal failure, and habitual abortion, are thought to be associated with the antiphospholipid syndrome. The authors describe a 32-year-old woman who had characteristics of the antiphospholipid syndrome including increased immunoglobulin G-cardiolipin antibody titers, iliofemoral vein thrombosis, pulmonary embolism, headache, visual disturbances, and habitual abortion. During hospitalization, she suddenly experienced right-sided weakness. A Tc-99m HMPAO brain scan showed the probability of a transient ischemic attack in the left frontotemporal cortex.

Topics: Adult; Antiphospholipid Syndrome; Brain; Female; Femoral Vein; Humans; Iliac Vein; Ischemic Attack, Transient; Pulmonary Embolism; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Aggregated Albumin; Technetium Tc 99m Exametazime; Venous Thrombosis

In this study, 99mTc-hexamethyl propyleneamine oxime (HMPAO) SPECT was used to evaluate the regional cerebral blood flow (rCBF) of the brain in patients with primary antiphospholipid antibody syndrome (PAPS).. 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.. 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.. HMPAO SPECT is a sensitive tool for detecting brain abnormalities in PAPS patients with only mild neuropsychiatric manifestations and normal brain MRI findings.

Topics: Adult; Antiphospholipid Syndrome; Brain; Cerebrovascular Circulation; Female; Humans; Middle Aged; Neurocognitive Disorders; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Topics: Adult; Antiphospholipid Syndrome; Brain; Cerebral Angiography; Cerebral Infarction; Cerebrovascular Disorders; Female; Humans; Lupus Erythematosus, Systemic; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Vasculitis