Sarbu Mihaela Ionela, Sarbu Nicolae
Saint Pierre University Hospital; Erasme Hospital, Rheumatology, Brussels, Belgium.
Department of Neuroradiology, Erasme Hospital, Brussels, Belgium.
Arch Rheumatol. 2020 Jan 8;35(3):443-448. doi: 10.46497/ArchRheumatol.2020.7544. eCollection 2020 Sep.
Brain atrophy, typically slowly progressive, is a hallmark of neuropsychiatric (NP) systemic lupus erythematosus (SLE). In this article, we report a case of a young female patient with previously diagnosed SLE, without known NPSLE, with abrupt neurological deterioration and rapidly progressive diffuse atrophy in a few months. A comprehensive diagnostic work-up and follow-up magnetic resonance imaging (MRI), including high-resolution advanced vessel-wall sequences, revealed underlying cerebral vasculitis. The novelty factors that the present report brings are the rapid progressive atrophy demonstrated on follow-up MRI in a patient with SLE, and the depiction of an underlying vasculitis on specific vessel-wall MRI techniques. We also reviewed the literature and discussed the main current applications of vessel-wall MRI sequences. The aim of the report is to recognize this dramatic form of presentation of NPSLE and the utility of the new MRI techniques for the diagnosis.
脑萎缩通常呈缓慢进展，是神经精神性（NP）系统性红斑狼疮（SLE）的一个标志。在本文中，我们报告了一例年轻女性患者，此前诊断为SLE，无已知神经精神性SLE，在几个月内出现突然的神经功能恶化和快速进展的弥漫性萎缩。全面的诊断检查和随访磁共振成像（MRI），包括高分辨率先进血管壁序列，显示存在潜在的脑血管炎。本报告带来的新因素是SLE患者随访MRI显示的快速进展性萎缩，以及特定血管壁MRI技术对潜在血管炎的描绘。我们还回顾了文献并讨论了血管壁MRI序列的主要当前应用。本报告的目的是认识到神经精神性SLE这种显著的表现形式以及新MRI技术在诊断中的实用性。
