Carneiro Eduarda, Reis Carina, Pinto Patrícia, Bernardes J Miguel, Ribeiro Silva Maria L, Salgado António
Serviços de Neurorradiologia e de Reumatologia, Hospital de São João, Porto, Portugal.
Acta Med Port. 2006 Nov-Dec;19(6):459-65. Epub 2007 May 14.
Patients with systemic lupus erythematosus (SLE) can develop dysfunction of the central nervous system (CNS) and have several neurologic syndromes with heterogeneous pathogenic mechanisms. The most common neurologic manifestations of SLE are organic mental syndromes, functional psychoses and seizures.
We retrospectively reviewed the magnetic resonance imaging (MRI) of SLE patients with CNS involvement followed in S. João Hospital Rheumatology clinic. Only patients with abnormal MRI were selected.
In 42 patients studied there were 22 (52,4%) cases with abnormal MRI. Patient's age ranged between 20 and 63 years (mean 35,6). All were females. MRI showed multiple periventricular white matter lesions in 16 cases (68,2%) and cerebral infarctions in 3 cases (13,6%). There were atrophic changes in 4 cases (18,2%) and cerebral hemorrhage in 2 cases (9,1%). There was a case (4,5%) of transverse myelitis associated with acute optic neuritis (Devic's syndrome) and 1 case (4,5%) of predominantly posterior white matter signal abnormalities (reversible posterior leukoencephalopathy syndrome).
This study confirms MRI importance on in identifying and characterizing CNS abnormalities, which contributes to better investigation and management of these patients. The authors discuss etiological possibilities of the different imagiological findings.
系统性红斑狼疮（SLE）患者可出现中枢神经系统（CNS）功能障碍，并伴有多种发病机制各异的神经综合征。SLE最常见的神经表现为器质性精神综合征、功能性精神病和癫痫发作。
我们回顾性分析了圣若昂医院风湿病诊所随访的CNS受累的SLE患者的磁共振成像（MRI）。仅选择MRI异常的患者。
在研究的42例患者中，22例（52.4%）MRI异常。患者年龄在20至63岁之间（平均35.6岁）。均为女性。MRI显示16例（68.2%）有多个脑室周围白质病变，3例（13.6%）有脑梗死。4例（18.2%）有萎缩性改变，2例（9.1%）有脑出血。有1例（4.5%）横贯性脊髓炎合并急性视神经炎（德维克综合征），1例（4.5%）主要为后部白质信号异常（可逆性后部白质脑病综合征）。
本研究证实了MRI在识别和表征CNS异常方面的重要性，这有助于对这些患者进行更好的检查和管理。作者讨论了不同影像学表现的病因可能性
