Alexander E L, Beall S S, Gordon B, Selnes O A, Yannakakis G D, Patronas N, Provost T T, McFarland H F
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ann Intern Med. 1988 Jun;108(6):815-23. doi: 10.7326/0003-4819-108-6-815.
Thirty-eight patients with the primary Sjögren syndrome, 16 with active neuropsychiatric manifestations and 22 without clinical evidence of central nervous system involvement had magnetic resonance (MR) imaging. Eight patients had focal neurologic deficits (6 of these also had psychiatric, or cognitive dysfunction), and 8 had psychiatric or cognitive abnormalities alone. Magnetic resonance imaging showed abnormal results in 12 of 16 (75%; 95% CI, 48 to 93) patients with active central nervous system disease (67 focal lesions predominantly within the subcortical and periventricular white matter), and in 2 of 22 (9%; 95% CI, 1 to 29) patients without clinical evidence of central nervous system disease (P less than 0.0001). Seven of eight patients with focal neurologic deficits and 5 of 8 patients with psychiatric or cognitive dysfunction alone had abnormal results on MR imaging. Magnetic resonance imaging was more sensitive in the subgroup with focal deficits, (sensitivity, 88%; 95% CI, 44 to 97) than computerized axial tomography or cerebral angiography. Magnetic resonance imaging detects focal cerebral lesions in patients with the Sjögren syndrome and central nervous system involvement, including patients with psychiatric and cognitive dysfunction alone.
38例原发性干燥综合征患者接受了磁共振成像检查，其中16例有活跃的神经精神表现，22例无中枢神经系统受累的临床证据。8例患者有局灶性神经功能缺损（其中6例也有精神或认知功能障碍），8例仅有精神或认知异常。磁共振成像显示，16例有活跃中枢神经系统疾病的患者中有12例（75%；95%可信区间，48%至93%）结果异常（67个局灶性病变主要位于皮质下和脑室周围白质），22例无中枢神经系统疾病临床证据的患者中有2例（9%；95%可信区间，1%至29%）结果异常（P<0.0001）。8例有局灶性神经功能缺损的患者中有7例，8例仅有精神或认知功能障碍的患者中有5例磁共振成像结果异常。磁共振成像在有局灶性缺损的亚组中更敏感（敏感性，88%；95%可信区间，44%至97%），优于计算机断层扫描或脑血管造影。磁共振成像可检测出干燥综合征合并中枢神经系统受累患者的局灶性脑病变，包括仅有精神和认知功能障碍的患者。
