Involvement of the brain is one of the most important complications of Sjögren's syndrome (SS). However, diagnosis of brain involvement in SS patients is difficult due to the lack of effective imaging methods. In this study, we compared two updated brain imaging modalities, 18F-2-fluoro-2-deoxy-D-glucose (FDG) PET and 99mTc-hexamethyl propyleneamine oxime (HMPAO) SPECT, in SS patients with neuropsychiatric manifestations, to detect glucose metabolism of the brain and regional cerebral blood flow.
Sixteen primary female SS patients with normal brain MRI findings were enrolled in this study.
Technetium-99m-HMPAO SPECT findings were abnormal in 13 (81%) patients. Parietal and temporal lobes were the most common areas of brain involvement. Fluorine-18-FDG PET findings were abnormal in 3 (19%) patients. Temporal lobes were the most common areas of brain involvement.
We conclude that brain HMPAO SPECT has better correlation with clinical manifestations than brain FDG PET or CT/MRI.