1Department of General and Interventional Radiology and Neuroradiology.
Lupus. 2014;23(1):10-9. doi: 10.1177/0961203313511556. Epub 2013 Nov 5.
Twenty-two neuropsychiatric (NPSLE) and 13 systemic lupus erythematosus (SLE) patients with a normal appearing brain on plain magnetic resonance (MR) as well as 20 age-matched healthy controls underwent MR spectroscopy (MRS), perfusion-weighted (PWI) and diffusion-tensor imaging (DTI). In MRS NAA/Cr, Cho/Cr and mI/Cr ratios were calculated from the posterior cingulate cortex and left parietal white matter. In PWI, values of cerebral blood volume (CBV) were assessed from 14 regions, including gray and white matter. In DTI fractional anisotropy (FA) values were obtained from 14 white matter tracts including projection, commissural and association fibers. All MR measurements were correlated with clinical data. SLE and NPSLE patients showed significantly (p < 0.05) lower NAA/Cr ratios within both evaluated regions and FA values within the cingulum, as well as a tendency to cortical hypoperfusion. Compared to SLE, NPSLE subjects revealed lower FA values within a wide range of association fibers and corpus callosum. Advanced MR techniques are capable of in vivo detection of complex microstructural brain damage in SLE and NPSLE subjects regarding neuronal loss, mild hypoperfusion and white matter disintegrity. MRS and DTI seem to show the highest usefulness in depicting early changes in normal appearing gray and white matter in SLE patients.
22 例神经精神性狼疮（NPSLE）和 13 例系统性红斑狼疮（SLE）患者磁共振平扫（MR）未见异常，以及 20 例年龄匹配的健康对照者接受了磁共振波谱（MRS）、灌注加权成像（PWI）和弥散张量成像（DTI）检查。MRS 中，从后扣带回皮质和左侧顶叶白质计算 N-乙酰天冬氨酸（NAA）/肌酐（Cr）、胆碱（Cho）/Cr 和肌酸（mI）/Cr 比值。在 PWI 中，从 14 个区域评估脑血容量（CBV）值，包括灰质和白质。在 DTI 中，从 14 个白质束获得各向异性分数（FA）值，包括投射纤维、连合纤维和联络纤维。所有 MR 测量均与临床数据相关。SLE 和 NPSLE 患者在两个评估区域内 NAA/Cr 比值显著降低（p<0.05），扣带回内 FA 值降低，皮质灌注不足趋势。与 SLE 相比，NPSLE 患者在广泛的联络纤维和胼胝体中 FA 值较低。先进的磁共振技术能够在 SLE 和 NPSLE 患者中检测到神经元丢失、轻度低灌注和白质完整性受损等复杂的脑微观结构损伤。MRS 和 DTI 似乎在显示 SLE 患者正常外观的灰质和白质早期变化方面最有用。
