Evaluation of regional cerebral blood flow with Tc-99m-HMPAO in primary antiphospholipid antibody syndrome

In this study, Tc-99m-hexamethyl propyleneamine oxime (HMPAO) SPECT was use d to evaluate the regional cerebral blood flow (rCBF) of the brain in patie nts 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, s erum anticardiolipin antibodies (ACA) and lupus anticoagulant (LA) were mea sured. 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 re sults were related to HMPAO SPECT findings. Conclusion: HMPAO SPECT is a se nsitive tool for detecting brain abnormalities in PAPS patients with only m ild neuropsychiatric manifestations and normal brain MRI findings.