Optimizing clinical monitoring of central nervous system involvement in SLE
Optimizing clinical monitoring of central nervous system involvement in SLE
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DOI：
10.1016/j.autrev.2007.11.022
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发表时间：
2008-02-01
影响因子：
13.6
通讯作者：
Trotta, F.
中科院分区：
文献类型：
--
作者：
Castellino, G.;Govoni, A.;Trotta, F.
中枢神经系统“CNS”受累是 SLE 的常见表现，发生在 15-75% 的患者中。然而，中枢神经系统受累的诊断是一项艰巨的任务，需要仔细的临床和实验室评估以及仪器评估。近年来，神经影像技术的重大进步使我们对 SLE 发病机制的了解有了很大的提高。无论如何，由于没有单一的成像技术涵盖所有脑部病理学，并且炎症和神经退行性变均与 SLE 发病机制有关，因此使用将形态学与功能成像模式相结合的多模态方法非常重要。在这种情况下，迄今为止，传统的磁共振成像和单光子发射计算机断层扫描是最常用和最容易获得的技术。灌注加权成像、扩散加权成像、磁化转移成像和磁共振波谱等现代技术为评估脑组织损伤提供了有用的信息，然而，它们在个体患者中的临床相关性需要进一步的证据。在这篇综述中，我们想总结过去几年我们在 NPSLE 神经影像学方面所学到的知识，神经影像技术的主要进展是什么，最后，我们想就日常临床实践中应如何处理有 NP 症状的 SLE 患者提出一些建议。 (c) 2007 Elsevier B.V 保留所有权利。
Central Nervous System 'CNS' involvement is a frequent SLE manifestation occurring in 15-75% of patients. However, diagnosis of CNS involvement is a difficult task and requires a careful clinical and laboratory assessment along with instrumental evaluation. In recent years major advances in neuroimaging techniques allowed a great improvement in our understanding of SLE pathogenesis. Anyway, since no single imaging technique covers all brain pathology and both inflammation and neurodegeneration contribute to SLE pathogenesis, it is very important to use a multimodality approach coupling a morphological with a functional imaging modality. In this setting, to date, conventional magnetic resonance imaging and single photon emission computed tomography are the most largely available and accessible techniques. Modem techniques such as perfusion weighted imaging, diffusion weighted imaging, magnetization transfer imaging and magnetic resonance spectroscopy provide useful information to assess brain tissue damage however, their clinical relevance in individual patients needs further evidence.In this review we would like to summarize what have we learned in the last few years about neuroimaging in NPSLE, what have been major advances in neuroimaging techniques and, finally, we would like to give some suggestions about what should be done in daily clinical practice to approach SLE patients with NP symptoms. (c) 2007 Elsevier B.V All rights reserved.