摘要
目的探讨系统性红斑狼疮脑病的MRI表现及诊断价值。方法回顾性分析24例临床已诊断为系统性红斑狼疮(SLE)且怀疑狼疮脑病的患者的头颅MRI片。结果有阳性表现者18例,阳性率75%。其中以脑炎表现较为典型(11例),其中脑炎基础上出血2例,其次为缺血损害灶及脑梗死改变(4例),软化灶1例,多发钙化灶1例。11例脑炎表现者MRI诊断为狼疮脑病,其余病例,均需进一步鉴别诊断。结论MRI对SLE患者且疑似狼疮脑病者是首选的检查方法。MRI对颅内病灶显示较CT敏感,特别是FLAIR序列效果显著,脑脊液信号被压抑后,皮层内病灶可清楚显示,对狼疮脑病早期诊断及判断疗效有极大帮助。狼疮脑病的MRI表现非特异性,需与病毒性脑炎、结核性脑炎及高血压病引起的脑梗塞等鉴别。
Object To study MRI feature and diagnostic value of neuropsychiatric systemic lupus erythematosus （named lupus encephalophthy also）. Methods 24 cases with diagnosis of systemic lupus erythematosus and also were selected. To analyze the MRI images. Result 18 patients have positive MRI sign in 24 cases including encephalitis , infarction , hemorrhage, cerebral atrophy. The abnormal findings appearing in deed white matter were common. Brain stem has not involved. Conclusion MRI is sensitive in displaying cerebral focus especcially FLAIR sequences. Using it can help us easily demarcating the brain infarction and myelin sheath. It is of great value in diagnosing the early disease and in judging therapeutic effect.
