Brain perfusion SPET and proton magnetic resonance spectroscopy in the evaluation of two systemic lupus erythematosus patients with mild neuropsychiatric manifestations

Colamussi, Paolo; Trotta, Francesco; Ricci, R.; Cittanti, Corrado; Govoni, Marcello; Barbarella, Giovanna; Giganti, Melchiore; Bajocchi, Gianluigi; Uccelli, Licia; Trevisan, Carlo P.; Piffanelli, A

doi:10.1097/00006231-199703000-00012

Cited by 25 publications

(14 citation statements)

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“…The patients included the two we have described previously 16 and fulfilled the 1982 American College of Rheumatology classification criteria for SLE. 17 The mean age of the patients (all women) was 31.8 years (range 15 to 48), and the mean duration of disease was 5.5 years.…”

Section: Methodsmentioning

confidence: 99%

“…[11][12][13][14][15] In a previous preliminary study using a multi-imaging coregistration approach, we found a topographic correlation between SPECT and metabolic abnormalities detected with 1 H-MRS in the absence of MRI lesions in two SLE patients. 16 Our aim in the present report was to verify-in a further six patients with SLE but without clinical evidence of major CNS involvement-whether perfusion defects detected by SPECT in areas free of MRI abnormalities correspond to areas of neuronal metabolic impairment detected by 1 H-MRS and, if so, whether such alterations can predict the appearance of new lesions detectable by MRI. …”

mentioning

confidence: 88%

“…This type of subjective evaluation has proved to be accurate for assessing both cerebral lupus and other diseases. 16 19 20 Magnetic resonance imaging MRI was carried out using a conventional 1.5 Tesla whole body MR imaging Magnetom SP 4000 (Siemens), using a standard circular polarised head coil. We acquired T1 sequences 1 H-Magnetic resonance spectroscopy 1 H-MR spectra were obtained using the same Siemens imager (1.5 Tesla whole body MR imaging Magnetom SP 4000, Siemens).…”

Section: Spectmentioning

confidence: 99%

“…1 H-MRS data were entered and processed in a one dimensional MR software package as previously reported. 16 In each patient all three imaging examinations were obtained within 48 hours using the following sequence: SPECT, MRI, 1 H-MRS. SPECT and MRI image analyses were first separately undertaken by two expert radiologists and then jointly after multimodal co-registration of the acquired volumes (done with statistical parametric mapping software using the ''maximisation of mutual information'' technique). Finally, a follow up re-evaluation was carried out in five patients in whom an MRI analysis was repeated between four and six years after the first instrumental evaluation (between January 2001 and December 2003).…”

Section: Spectmentioning

confidence: 99%

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Proton magnetic resonance spectroscopy may predict future brain lesions in SLE patients: a functional multi-imaging approach and follow up

Castellino

Govoni²,

Padovan³

et al. 2005

Annals of the Rheumatic Diseases

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Objective: To determine whether single photon emission tomography (SPECT) and magnetic resonance spectroscopy ( 1 H-MRS) can predict the appearance of new lesions in systemic lupus erythematosus (SLE), detectable by magnetic resonance imaging (MRI). Methods:99 Tc m -HMPAO-SPECT, brain MRI, and 1 H-MRS were done in eight women with SLE (mean age 31.8 years; disease duration 5.5 years). NAA/Cho, NAA/Cre, and Cho/Cre ratios were assessed in hypoperfused and normoperfused areas detected by SPECT that were normal on MRI examination. Reference values were obtained in 20 normal healthy controls. In five patients, MRI was repeated four to six years after the first evaluation. Results: Mean NAA/Cho and Cho/Cre ratios in hypoperfused and normoperfused frontal areas were, respectively, lower and higher than control. There were no differences in NAA/Cre ratios. Mean Cho/Cre ratios were increased in hypoperfused v normoperfused brain areas (mean (SD): 1.43 (0.27) v 1.00 (0.07); p,0.023). NAA/Cre ratios were not altered (2.18 (0.30) v 1.99 (0.28); p = 0.381). Three of five patients who had a second MRI had new lesions in areas previously abnormal on MRS and SPECT but normal on first MRI. One patient with positive MRI, SPECT, and MRS showed an increase in the number of MRI lesions; one patient with negative MRI, SPECT, and MRS did not show any new lesions. Conclusions: Abnormalities reflecting altered perfusion or neuronal-chemical changes can be demonstrated by functional imaging techniques even in the absence of morphological lesions detectable by MRI. The abnormal areas identified by SPECT and MRS may predict future parenchymal damage.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 88%

Section: Spectmentioning

confidence: 99%

Section: Spectmentioning

confidence: 99%

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Proton magnetic resonance spectroscopy may predict future brain lesions in SLE patients: a functional multi-imaging approach and follow up

Castellino

Govoni²,

Padovan³

et al. 2005

Annals of the Rheumatic Diseases

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“…Diese Veränderun-gen können potentiell reversibel sein [16], insbesondere unter hoch dosierter Kortikosteroidtherapie [37]. Die MRspektroskopischen Veränderungen korrelieren mit Perfusionsänderungen, die mittels SPECT nachgewiesen werden können [19]. Die MRS ist jedoch aufwendig und artefaktanfällig, und dadurch weniger breit verfügbar.…”

Section: ❑ Spectunclassified

Neuropsychiatrische Beteiligung des systemischen Lupus erythematodes

Weiner

Otte

Uhl

et al. 2003

Medizinische Klinik

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The treatment of cerebral lupus is empiric, due to a lack of randomized studies. Inflammatory brain lesions are treated with corticosteroids and immunosuppressive drugs (e. g., cyclophosphamide). Anticoagulant therapy with coumarins (at a target INR of 3.0-3.5) is recommended in cases of thrombotic events associated with antiphospholipid antibodies. However, no studies exist on patients with arterial thrombosis, including strokes, supporting this target INR.

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