系统性红斑狼疮脑病的临床与影像学表现

Clinical and imaging manifestations of neuropsychopathy in systemic l upus erythematosus

目的:研究系统性红斑狼疮脑病(NPSLE)患者临床与影像学特点。方法:对28例NPSLE患者进行临床与影像分析。结果:临床表现:头痛、癫痫、脑血管意外、颅神经病变、颅内压增高等神经症状,多合并有精神综合征等。全部患者脑脊液检查存在异常。影像表现:CT扫描阳性率为85.71%(24?28),MRI扫描阳性率为90.48%(19?21),MRI较CT敏感性高。二者表现:①脑内灰白质弥漫性及局灶性低密度;②脑萎缩;③脑内小灶性出血;④基底节钙化;⑤正常。结论:NPSLE影像表现特异性不强,但CT与MRI对NPSLE的早期诊断及疗效观察提供重要参考价值,对NPSLE的诊断必须密切结合其它临床资料。

Objective: To study clinical and imaging manifestations of patient s with NPSLE. Method: The author reviewed imaging findings and the clinical mani festations in 28 cases of NPSLE. Result: The clinical manifestations were: heada che, seizure, cerebrovascular accident, lesion of cranial nerve, intracranial hy pertension and meningitis which mostly were combined with disorders of conscious ness, cognition and amentia etc. Results of laboratory examination of cerebrospi nal fluid in the 28 patients were abnormal. The imaging manifestations were: pos itive CT findings was 85.71%(24/28). Positive MRI signs was 90.48%(19/21). MRI w as more sensitive than CT. CT and MRI showed: ①diffuse and localized low densit y, hypointense and hyperintense lesions on CT, T1WI and T2WI respectively in the white and grey matter; ②cerebral atrophy; ③small hemorrhagic lesions; ④basal ganglia calcification; ⑤normal. Conclusion: Imaging changes in patients with N PSLE had poor specificity. CT and MRI could provide valuable information for the early diagnosis and for the evaluatian of the treatment. To confirm the diagnos is of NPSLE, a combination with the other clinical data was necessary.