Evaluaci車n del compromiso neuropsiqui芍trico mediante SPECT cerebral en las enfermedades col芍geno-vasculares

作者：Ferrando; Rodolfo; Lecot; Carlos; Cairoli; Ernesto; Silveira; Alicia

来源：Alasbimn Journal, 2010.

• SPECT cerebral
• flujo sanguineo cerebral regional
• enfermedades colagenovasculares
• sintomas neuropsiquiatricos
• LES
• Beh et
• Brain SPECT
• regional cerebral blood flow
• connective tissue diseases
• neuropsychiatric symptoms
• SLE
• Beh et disease.

ResumenObjetivoEstudiar el valor del SPECT cerebral en el diagn車stico y control evolutivo del compromiso del SNC en las enfermedades col芍genovasculares (ECV) con sintomatolog赤a neuropsiqui芍trica (SNP).Materiales y m谷todosSe analizaron retrospectivamente 31 pacientes consecutivos portadores de ECV con SNP evaluados mediante SPECT cerebral con 99mTc-ECD y mapas estad赤sticos de superficie cortical. Veintiuno de ellos presentaban LES y 6 una enfermedad de Beh et. A 18 pacientes se efectu車 adem芍s TC, a 8 RM y a 10 estudio neuropsicol車gico (ENP). Seis pacientes se realizaron SPECT de control.ResultadosVeintiocho pacientes presentaron SPECT patol車gico. La TC fue anormal en s車lo 3/18 (sensibilidad 90,3% vs. 16,7%; p%26lt;0,001). La RM mostr車 alteraciones en 5/8 pacientes y el ENP en 7/10. Aunque todos estos pacientes presentaron SPECT patol車gico, los valores de sensibilidad no difirieron significativamente. Los pacientes con mayor SNP presentaron trastornos de perfusi車n m芍s extensos (p%26lt;0,035). Los pacientes estudiados evolutivamente mostraron mejor赤a de los defectos con la respuesta al tratamiento y agravamiento con la reaparici車n de s赤ntomas.ConclusionesEl SPECT cerebral presenta elevada sensibilidad en la detecci車n del compromiso neuropsiqui芍trico en las ECV. Su utilidad podr赤a extenderse al control evolutivo y la evaluaci車n de la respuesta terap谷utica. AbstractObjetiveTo study the value of brain SPECT in the diagnosis and follow up of SNC involvement in systemic connective tissue diseases (SCTD) with neuropsychiatric symptoms (NPS).Materials and methodsWe retrospectively analyzed 31 consecutive patients with SCTD presenting with NPS who underwent 99mTc-ECD SPECT and statistical surface maps. 21 patients had systemic lupus erythematosus and 3 had Beh et disease. Results were compared to those of CT (18/31), MRI (8/31) and neuropsychological examination (NPE). 6 patients had follow-up SPECT scans.ResultsTwenty-eight patients had abnormal SPECT studies. CT was abnormal in 3/18 patients (sensitivity 90.3% vs. 16.7%; p%26lt;0.001). MRI showed alterations in 5/8 patients and NPE in 7/10. Although all these patients presented abnormal SPECT scans, sensitivity values were not statistically different. Patients with major NPS presented more extensive perfusion defects (p%26lt;0.035). Patients with follow-up SPECT scans showed perfusion improvement with response to treatment and progression of the alterations when symptoms relapsed.ConclusionBrain SPECT presents high sensitivity for the detection of neurological involvement in SCTD. SPECT usefulness may extend to follow-up and evalua

• 出版日期2010