A multimodal MRI approach to identify and characterize microstructural brain changes in neuropsychiatric systemic lupus erythematosus.
A multimodal MRI approach to identify and characterize microstructural brain changes in neuropsychiatric systemic lupus erythematosus.
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DOI：
10.1016/j.nicl.2015.05.002
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发表时间：
2015
影响因子：
4.2
通讯作者：
Ronen, Itamar
中科院分区：
文献类型：
--
作者：
Ercan, Ece;Ingo, Carson;Tritanon, Oranan;Magro-Checa, Cesar;Smith, Alex;Smith, Seth;Huizinga, Tom;van Buchem, Mark A.;Ronen, Itamar
关键词：
系统性红斑狼疮（SLE）是一种累及多器官的自身免疫性疾病，高达40%的患者会出现神经和精神（NP）症状。迄今为止，由于缺乏神经放射学金标准，神经精神系统性红斑狼疮（NPSLE）的诊断提出了一个挑战。在本研究中，我们旨在通过结合两种定量MRI技术，扩散张量成像（DTI）和磁化转移成像（MTI）的数据，更好地定位和表征NPSLE中正常出现的白质（NAWM）变化。研究对象包括9例活动性NPSLE患者（37±13岁，均为女性）、9例无NP症状的SLE患者（44±11岁，均为女性）和14例健康对照（HC）（40±9岁，均为女性）。在3t MRI扫描仪上收集所有受试者的MTI、DTI和流体衰减反转恢复（FLAIR）图像。基于FLAIR图像为每位受试者创建磁化传递比（MTR）、平均扩散率（MD）、分数各向异性（FA）、径向扩散率（RD）、轴向扩散率（AD）图和白质病变图。然后使用基于束的空间统计和累积病变图对MTR和DTI数据进行联合分析，以排除病变。与NAWM地区的HC相比，NPSLE地区的MTR和FA显著降低，AD、RD和MD显著升高。然而，DTI测量和MTR的差异仅中度共定位。此外，在NPSLE和SLE患者之间，DTI测量值存在显著差异，但MTR没有，这表明MD检测到的潜在微结构变化与NPSLE的发病有关。MTI和DTI测量的解剖分布联合分析可以潜在地提高NPSLE的诊断，并有助于了解潜在的微结构损伤。利用MTI和DTI研究NPSLE和SLE的NAWM。NPSLE和HC之间的DTI和MTR差异普遍存在，但仅中度共定位。SLE和NPSLE之间MD的显著差异提示与NPSLE的发病有关。
Systemic lupus erythematosus (SLE) is an autoimmune disease with multi-organ involvement and results in neurological and psychiatric (NP) symptoms in up to 40% of the patients. To date, the diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) poses a challenge due to the lack of neuroradiological gold standards. In this study, we aimed to better localize and characterize normal appearing white matter (NAWM) changes in NPSLE by combining data from two quantitative MRI techniques, diffusion tensor imaging (DTI) and magnetization transfer imaging (MTI). 9 active NPSLE patients (37 ± 13 years, all females), 9 SLE patients without NP symptoms (44 ± 11 years, all females), and 14 healthy controls (HC) (40 ± 9 years, all females) were included in the study. MTI, DTI and fluid attenuated inversion recovery (FLAIR) images were collected from all subjects on a 3 T MRI scanner. Magnetization transfer ratio (MTR), mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD) maps and white matter lesion maps based on the FLAIR images were created for each subject. MTR and DTI data were then co-analyzed using tract-based spatial statistics and a cumulative lesion map to exclude lesions. Significantly lower MTR and FA and significantly higher AD, RD and MD were found in NPSLE compared to HC in NAWM regions. The differences in DTI measures and in MTR, however, were only moderately co-localized. Additionally, significant differences in DTI measures, but not in MTR, were found between NPSLE and SLE patients, suggesting that the underlying microstructural changes detected by MD are linked to the onset of NPSLE. The co-analysis of the anatomical distribution of MTI and DTI measures can potentially improve the diagnosis of NPSLE and contribute to the understanding of the underlying microstructural damage. NAWM is investigated in NPSLE and SLE using MTI and DTI. Differences in DTI and MTR between NPSLE and HC are widespread but only moderately co-localized. Significant differences in MD between SLE and NPSLE suggest link to onset of NPSLE.
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影响因子：
5.7
作者：
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通讯作者：
Smith, S
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