神经精神狼疮MRI诊断

MRI diagnosis of neuropsychiatric lupus

目的研究系统性红斑狼疮的头部MRI表现特点,病灶的好发部位及分布情况。方法收集盛京医院风湿免疫病房做过头MRI检查的SLE患者,回顾性分析总结其影像特点,并且根据是否确诊为NPSLE分为NPSLE组和非NPSLE组两个亚组进行影像表现类型、病灶好发部位及灰白质分布情况几方面的比较。结果收集到符合条件的SLE患者69人,头部MRI影像表现多样,有多灶性脑白质病、脑萎缩、大面积梗塞、脑炎样改变、脑干梗塞。其中脑炎样改变及小脑大面积梗塞仅见于NPSLE组患者,病变主发生在额叶、顶叶的脑白质,和岛叶的脑灰质。很多年轻SLE患者发生了脑萎缩。结论 NPSLE患者脑内病变好发于额、顶叶的脑白质及岛叶的脑灰质。脑炎样改变及小脑的大面积梗塞可能会成为NPSLE相对特异的改变。年轻SLE患者发生脑萎缩应引起高度重视。

Objective To research the manifestations, the predilection sites and distribution of neuropsychiatric lupus in mag- netic resonance imaging. Methods We retrospectively analyzed the imaging features of 69 SLE patients hospitalized in rheumato- logical ward of Shengjing hospital. They were divided into NPSLE group and non-NPSLE group and imaging manifestations, loca- tions and distributions were compared between the two groups. Results MRI imaging manifestations of SLE patients are various. They are multifoeal cerebral white matter lesions, brain atrophy, large area infarction of the brain and cerebellum, encephalitis- like changes, brain stem infarction. Lesions are likely to occur in the white matter of frontal lobes and parietal lobes and the gray matter of insular lobes. Brain atrophy occurs in many young SLE patients. Conclusion Encephalitis-like changes and large area infarction of the cerebellum may be specific to NPSLE. SLE patients with brain lesions prefer to occur in the white matter of frontal lobes and parietal lobes and the gray matter of insular lobes. Brain atrophy in young SLE patients should be paid much more con- cern.