Related Experiment Video
Updated: Aug 30, 2026
Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies
Published on: November 19, 2020
Cerebral blood flow assessed by brain SPECT with 99mTc-HMPAO utilising the acetazolamide test in systemic lupus
P Lass1, M Koseda, G Romanowicz
1Department of Nuclear Medicine, Medical University, Gdańsk, Poland.
Insights
Systemic lupus erythematosus (SLE) patients frequently exhibit cerebral blood flow (CBF) asymmetries. The acetazolamide test revealed varied responses, indicating complex cerebrovascular changes in SLE.
Area of Science:
- Neurology
- Radiology
- Rheumatology
Background:
- Cerebrovascular diseases are a major complication of Systemic Lupus Erythematosus (SLE).
- Diagnosing neuropsychiatric complications in SLE patients using imaging is challenging.
- This study investigated cerebral blood flow (CBF) and its reactivity to hypercapnia in SLE patients.
Purpose of the Study:
- To assess cerebral blood flow (CBF) characteristics in SLE patients.
- To evaluate the cerebrovascular reactivity to hypercapnia using the acetazolamide test in SLE.
- To identify potential differences in CBF patterns between SLE patients with and without antiphospholipid syndrome.
Main Methods:
- 50 SLE patients underwent brain SPECT (SPELT) using 99mTc-HMPAO.
- 35 patients received an acetazolamide test (1.0 g i.v.) 3 days post-baseline with repetitive scanning.
- MRI was performed to detect cerebral lesions.
Main Results:
- 76.3% of SLE patients showed interhemispheric hypoperfusion.
- Antiphospholipid syndrome patients exhibited multifocal perfusion deficits.
- Acetazolamide test responses were heterogeneous; 41% of patients had cerebral lesions on MRI.
Conclusions:
- CBF asymmetries are common in both symptomatic and asymptomatic SLE patients.
- Regional CBF alterations differ in SLE patients with and without antiphospholipid syndrome.
- Some SLE patients display absent or paradoxical reactions to acetazolamide, suggesting altered cerebrovascular reserve.
Background:
Cerebrovascular diseases are one of the most important complications of systemic lupus erythematosus (SLE). The diagnostic imaging of neuropsychiatric SLE complications presents many problems. This study was undertaken to investigate cerebral blood flow char s and its reactivity to hypercapnia by means of acetazolamide test in SLE patients.
Methods:
Brain SPELT studies using 99mTc-HMPAO were performed in 50 patients with SLE. Acetazolamide test was performed in 35 patients 3 days after the baseline study by means of repetitive scanning 20 min after i.v. injection of 1.0 g of acetazolamide.
Results:
Significant interhemispheric hypoperfusion areas were shown in 76.3% of all patients, 83.8% symptomatic and 63.1 % asymptomatic. Patients with antiphospholipid syndrome showed multifocal perfusion deficits. The reaction of cerebral perfusion to acetazolamide was heterogenous and showed increase, decrease, no change or mixed reaction of baseline-study-found focal hypoperfusion. Acetazolamide test revealed hypoperfusion in two patients with normal baseline study. MRI scanning revealed cerebral lesions in 41 % of patients.
Conclusions:
CBF asymmetries in symptomatic and asymptomatic patients with SLE are frequent. Regional CBF alterations seem to be different in patients with and without antiphospholipid syndrome. The part of the patients with SLE shows no or paradoxically inversed reaction to acetazolamide.
