Harirchian Mohammad Hossein, Saberi Hazhir, Najafizadeh Seyed Reza, Hashemi Seyed Ali
Department of Neurology, Imam Khomeini Hospital, Iranian Center of Neurological Research, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Radiol. 2011 Nov;8(3):157-60. doi: 10.5812/kmp.iranjradiol.17351065.3138. Epub 2011 Nov 25.
Central nervous system (CNS) involvement has been observed in 14-80% of patients with systemic lupus erythematosus (SLE). Magnetic resonance imaging (MRI) is an appropriate method for evaluating CNS involvement in these patients. Clinical manifestations and MRI findings of CNS lupus should be differentiated from other mimicking diseases such as multiple sclerosis (MS).
The aim of this study was to evaluate the prevalence and extent of brain and cervical cord MRI lesions of lupus patients. The relationship between neurological signs and symptoms and MRI findings were evaluated as well.
Fifty SLE patients who had been referred to the rheumatology clinic of our hospital within 2009 were included in a cross sectional study. All patients fulfilled the revised 1981 American College of Rheumatology (ACR) criteria for SLE. We evaluated the neurological signs and symptoms and brain and cervical MRI findings in these patients.
Forty-one patients (82%) were female and nine (18%) were male. The mean age was 30.1 ± 9.3 years. Twenty eight (56%) patients had an abnormal brain MRI. No one showed any abnormality in the cervical MRI. The lesions in 20 patients were similar to demyelinative plaques. Seventeen patients with abnormal brain MRI were neurologically asymptomatic. There was only a significant relationship between neurological motor manifestations and brain MRI abnormal findings.
Unlike the brain, cervical MRI abnormality and especially asymptomatic cord involvement in MRI is quite rare in SLE patients. This finding may be helpful to differentiate SLE from other CNS disorders such as MS.
在14% - 80%的系统性红斑狼疮（SLE）患者中观察到中枢神经系统（CNS）受累。磁共振成像（MRI）是评估这些患者中枢神经系统受累情况的合适方法。中枢神经系统狼疮的临床表现和MRI表现应与其他类似疾病如多发性硬化症（MS）相鉴别。
本研究旨在评估狼疮患者脑和颈髓MRI病变的患病率及范围。同时评估神经体征和症状与MRI表现之间的关系。
一项横断面研究纳入了2009年转诊至我院风湿科门诊的50例SLE患者。所有患者均符合1981年美国风湿病学会（ACR）修订的SLE诊断标准。我们评估了这些患者的神经体征和症状以及脑和颈髓的MRI表现。
41例（占82%）为女性，9例（占18%）为男性。平均年龄为30.1±9.3岁。28例（占56%）患者脑MRI异常。颈髓MRI均无异常。20例患者的病变类似于脱髓鞘斑块。17例脑MRI异常的患者无神经症状。仅神经运动表现与脑MRI异常表现之间存在显著相关性。
与脑部不同，SLE患者颈髓MRI异常，尤其是MRI显示的无症状脊髓受累情况相当罕见。这一发现可能有助于将SLE与其他中枢神经系统疾病如MS相鉴别。
