SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY ANALYSIS OF CEREBRAL BLOOD-FLOW IN THE EVALUATION OF CENTRAL-NERVOUS-SYSTEM INVOLVEMENT IN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS

Objective. Single-photon-emission computed tomography (SPECT) scanning was used to detect potential central nervous system (CNS) involvement in patients with systemic lupus erythematosus (SLE), by determining c erebral blood flow abnormalities. Methods. SPECT scans were performed on 35 SLE patients, grouped into 3 categories: those without neuropsyc hiatric symptoms (n = 10), those with definite neurologic or psychiatr ic disorders (n = 10), and those with mild symptoms such as headache o r memory disturbances (n = 15). SPECT scan features were classified as normal or as focal or diffuse defects in uptake. Results. SPECT findi ngs were normal in 9 of the 10 patients without CNS symptoms, and abno rmal in 9 of the 10 patients with overt neuropsychiatric disease (with motor or sensory deficits). Interestingly, only 4 of the 15 patients (26.7%) with mild symptoms suggestive of CNS disease had normal SPECT findings; the 11 remaining patients showed focal (53.3%) or diffuse (2 0%) uptake defects. An association between SPECT findings and disease duration was also observed, but there was no correlation of SPECT resu lts with overall disease activity, serologic findings, or medications used. Conclusion. Our data suggest that in a substantial proportion of patients, SPECT analysis may provide additional information on potent ial CNS involvement, and may therefore be useful in therapeutic decisi on-making and disease monitoring in order to prevent CNS damage.