Brain SPECT on Regional Cerebral Blood Flow to Objectively Evaluate the Therapy Effects of Anticoagulant in Patients with Primary Antiphospholipid Antibody Syndrome

Abstract

Objectives. Technetium-99m ethyl cysteinate dimer (99mTc ECD) brain single photon emission computed tomography (SPECT) was used to evaluate the effects of anticoagulant therapy (ACT) on regional cerebral blood flow (rCBF) in patients with primary antiphospholipid antibody syndrome (PAPS). Methods. Twelve female PAPS patients with neuropsychiatric manifestations and hypoperfusion lesions demonstrated on the initial 99mTc ECD brain SPECT images were enrolled in this study. Follow-up 99mTc ECD brain SPECT images were performed 1 month after ACT. Meanwhile, before and after ACT, serum anti-cardiolipin antibodies (ACA) and lupus anticoagulant (LA) were measured. Results. Before ACT, 9 (75.0%) patients had positive ACA and 7 (58.3%) patients had positive LA. After ACT, all of the 20 PAPS patients demonstrated negative serologic findings and no neuropsychatric manifestations. After ACT, 8 (66.7%) patients had completed recovery and 4 (33.3%) patients had partial recovery of rCBF in the follow-up 99mTc ECD brain SPECT images. Conclusions. 99mTc ECD brain SPECT images is a logical and objective tool to measure the effects of ACT in PAPS patients with brain involvement by determination of rCBF change.