BRAIN PERFUSION SPET AND PROTON MAGNETIC-RESONANCE SPECTROSCOPY IN THE EVALUATION OF 2 SYSTEMIC LUPUS-ERYTHEMATOSUS PATIENTS WITH MILD NEUROPSYCHIATRIC MANIFESTATIONS

The diagnosis of central nervous system (CNS) involvement appears to b e a major problem in systemic lupus erythematosus (SLE), especially wh en the clinical signs are non-specific or neuroimaging is unremarkable . Two SLE patients with mild neuropsychiatric manifestations were stud ied with magnetic resonance imaging (MRI), single photon emission tomo graphy (SPET) and localized proton magnetic resonance spectroscopy (H- l MRS). MRI was normal in both patients. SPET revealed areas of hypope rfusion in both patients. H-1 MRS demonstrated metabolic abnormalities in the regions corresponding to the hypoperfused areas. A correlation between H-1 MRS and SPET was noted: patients with mild neuropsychiatr ic SLE may have disturbances evident on SPET and H-1 MRS in the presen ce of normal anatomy on MRI, suggesting that CNS involvement in SLE ha s very strong physiological and neurometabolic components in individua l patients.