Jennings J E, Sundgren P C, Attwood J, McCune J, Maly P
Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor 48109, USA.
Neuroradiology. 2004 Jan;46(1):15-21. doi: 10.1007/s00234-003-1049-2. Epub 2003 Nov 27.
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.
我们的目的是回顾疑似神经精神性系统性红斑狼疮（NP-SLE）患者常规MRI上信号异常的频率和模式。我们回顾了85例系统性红斑狼疮患者（81名女性，4名男性，年龄21-78岁，平均40.6岁）出现神经功能障碍时进行的116次脑部MRI检查。34%的MRI结果正常或接近正常。60%的患者在T2加权图像上观察到高信号病变，常见于额叶和顶叶皮质下白质。21例出现累及灰质和白质的梗死样病变。67例接受弥散加权成像的患者中有12例出现弥散受限区域。其他异常包括脑容量减少、出血、脑膜强化以及枕叶白质双侧高信号。仅MRI表现无法使我们在许多患者中区分血栓栓塞性事件和炎症性事件。一些MRI正常的患者在接受免疫抑制治疗后临床症状改善。对于这些疑似NP-SLE的患者亚组，应研究更敏感和/或特异的成像方法，如磁共振波谱成像和灌注加权成像。
