Technetium-99m-HMPAO brain SPECT in Sjögren's syndrome

Technetium-99m-hexamethylpropylene amine oxime (HMPAO) brain images with fanbeam SPECT, in combination with surface three-dimensional display, were used to detect basal ganglion and cerebral cortex anomalies in Sjögren's syndrome patients. Forty-eight female Sjögren's syndrome patients with normal brain CT or magnetic resonance imaging findings were enrolled in this study and were investigated using 99mTc-HMPAO brain images with fanbeam SPECT and surface three-dimensional display. These patients were separated into two subgroups. Group 1 consisted of 38 patients with definite neuropsychiatric symptoms/signs and Group 2 consisted of 10 patients without any neuropsychiatric symptoms/signs. Fanbeam SPECT demonstrated unilateral or bilateral hypoactivity of basal ganglia and thalamus in 14% and 0% of patients in Groups 1 and 2, respectively. Using surface three-dimensional display of the brain, local hypoactivity anomalies were found in the brain cortex of 53% and 20% of patients in Groups 1 and 2, respectively. In Group 1 patients, parietal lobes were the most common areas of brain involvement. The cerebellum and thalamus were the least common areas of brain involvement. In Group 2 patients, parietal and temporal lobes were the most common areas of brain involvement. This study suggests that 99mTc-HMPAO brain imaging with fanbeam SPECT, in combination with surface three-dimensional display, is a sensitive tool for detecting regional cerebral anomalies in Sjögren's syndrome patients with and without neuropsychiatric symptoms/signs.