Value of MRI of the brain in patients with systemic lupus erythematosus and neurologic disturbance
Value of MRI of the brain in patients with systemic lupus erythematosus and neurologic disturbance
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DOI：
10.1007/s00234-003-1049-2
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发表时间：
2004-01-01
期刊：
影响因子：
2.8
通讯作者：
Maly, P
中科院分区：
文献类型：
--
作者：
Jennings, JE;Sundgren, PC;Maly, P
我们的目的是回顾可疑神经精神系统性红斑狼疮（NP-SLE）患者常规MRI信号异常的频率和模式。我们回顾了85例SLE患者（81例女性，4例男性，年龄21 - 78岁，平均40.6岁）的116次脑部MRI检查，这些患者表现为神经系统障碍。MRI正常或接近正常者占34%。60%的患者在T2加权像上观察到高信号病变，常见于额叶和顶叶皮质下白色物质。其中21例表现为累及灰质和白色物质的类梭状病变。在接受弥散加权成像的67例患者中，有12例出现弥散受限区域。其他异常包括脑体积减少、出血、脑膜强化和双侧枕叶白质高信号。在许多患者中，仅凭MRI结果无法区分血栓栓塞和炎症事件。一些MRI正常的患者在接受免疫抑制治疗时临床症状改善。在这些疑似NP-SLE患者亚组中，应研究更敏感和/或特异的成像方法，如光谱学和灌注加权成像。
Our objective was to review the frequency and pattern of signal abnormalities seen on conventional MRI in patients with suspected neuropsychiatric systemic lupus erythematosus (NP-SLE). We reviewed 116 MRI examinations of the brain performed on 85 patients with SLE, (81 women, four men, aged 21-78 years, mean 40.6 years) presenting with neurological disturbances. MRI was normal or nearly normal in 34%. In 60% high-signal lesions were observed on T2-weighted images, frequently in the frontal and parietal subcortical white matter. Infarct-like lesions involving gray and white matter were demonstrated in 21 of cases. Areas of restricted diffusion were seen in 12 of the 67 patients who underwent diffusion-weighted imaging. Other abnormalities included loss of brain volume, hemorrhage, meningeal enhancement, and bilateral high signal in occipital white-matter. The MRI findings alone did not allow us to distinguish between thromboembolic and inflammatory events in many patients. Some patients with normal MRI improved clinically while on immunosuppressive therapy. More sensitive and/or specific imaging methods, such as spectroscopy and perfusion-weighted imaging, should be investigated in these subgroups of patients with suspected NP-SLE.