title: Use of technetium-99m hexamethylpropylene amine oxime SPET for the study of cerebral blood flow reactivity after acetazolamide infusion in patients with Behçet's disease.
abstract: The purpose of this study was to characterise the nature of the baseline perfusion defects found in patients with Behçet's disease using hexamethylpropylene amine oxime single-photon emission tomography in conjunction with acetazolamide test (Acz SPET). Eleven patients underwent both baseline and Acz SPET. Regions of interest (ROIs) were drawn on the areas with decreased perfusion (D-ROI) and, in the same section, on areas with normal perfusion (N-ROI). The ROIs were then repositioned on the corresponding section on Acz SPET. The mean ROI counts were then transformed into a perfusion index value (PIV) with reference to the global brain counts. In total we found 24 D-ROIs (17 in the cortical and 7 in subcortical grey matter). The influence of Acz infusion was selectively registered in the D-ROIs, where PIVs changed from 1.23+/-0.17 (baseline SPET) to 1.63+/-0.23 (Acz SPET) (P<0.001). No significant difference was seen in the N-ROIs (1.46+/-0.21 and 1.40+/-0.17, respectively, on baseline SPET and Acz SPET). Our results demonstrate that Acz infusion increases the regional cerebral blood flow within baseline grey matter perfusion defects. This finding suggests that baseline perfusion abnormalities could reflect a disconnection rather than local vasculitic involvement.
authors.affiliation: Department of Clinical Physiopathology, Careggi Hospital, University of Florence, Italy. a.pupi@dfc.unifi.it
authors.forename: A
authors.initials: A
authors.lastname: Pupi
authors.forename: S
authors.initials: S
authors.lastname: Sestini
authors.forename: M T
authors.initials: MT
authors.lastname: De Cristofaro
authors.forename: L
authors.initials: L
authors.lastname: Emmi
authors.forename: T
authors.initials: T
authors.lastname: Marchione
authors.forename: G
authors.initials: G
authors.lastname: Salvati
authors.forename: F L
authors.initials: FL
authors.lastname: Gobbi
authors.forename: L
authors.initials: L
authors.lastname: Massacesi
authors.forename: U
authors.initials: U
authors.lastname: Meldolesi
mesh_terms: D000086:Acetazolamide / Q000494:pharmacology*; D000328:Adult; D001528:Behcet Syndrome / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019690:Technetium Tc 99m Exametazime; D000086:Acetazolamide