系统性红斑狼疮脑病的MRI诊断

Magnetic Resonance Imaging Features of Systemic Lupus Erythematosus Encephalopathy

目的探讨系统性红斑狼疮脑病(SLEE)的磁共振成像(MRI)特征和诊断价值。方法回顾性分析2007年1月-2009年7月间18例SLEE的临床表现及MRI特征。结果 18例患者MRI检查的颅脑阳性率为88.88%(16/18),脑部MRI表现为:①15例为多发病灶,局灶者1例。②双侧大脑半球、基底节区及小脑半球脑实质内长T1、长或稍长T2信号,DWI及EPI成像上呈高或稍高信号,灰白质均可受累,分布无规律性。③增强MRI扫描9例,其中5例呈斑片状强化,4例无明显强化。④脑梗死12例,脑出血4例。合并脑水肿9例,脑萎缩7例。结论 SLEE的MRI表现多样,结合临床资料,MRI可以作出诊断。

Objective To investigate the magnetic resonance imaging （MRI） features of systemic lupus erythematosus encephalopathy （SLEE） and its diagnostic value.Methods The clinical data and MRI images of 18 patients with SLEE admitted from January 2007 to July 2009 in our hospital were analyzed retrospectively.Results Positive findings were found in 16 patients （88.88% ）.MRI findings of SLEE were the following：①A Total of 15 patients were with diffuse lesions,one patient was with focal lesions.②Cerebral hemisphere involvement and bilateral caudate long T1 and long or slightly long T2 signal were intensive in the brain parenchyma,and appeared as hyper-intensity or slightly hyper-intensity on DWI and EPI.Grey and white matters were involved often and irregularly distributed.③The results of 9 patients by enhanced MRI showed that 5 patients were with patchy enhancement and 4 were without enhancement.④Of the 16 positive patients,12 were with cerebral infarction and 4 with cerebral hemorrhage,while 9 patients were complicated with cerebral edema,and 7 patients were with cerebral atrophy.Conclusion MRI manifestations of SLEE are various.Combined with clinical data, MRI can diagnose SLEE exactly.