[Detection of intracranial lesions of rheumatoid vasculitis with magnetic resonance imaging (MRI)].
Vasculitis in malignant courses of rheumatoid arthritis is found in many systems, but rarely in the central nervous system. It has been reported that magnetic resonance imaging (MRI) is capable of depicting minute infarctions and/or lesions of demyelination more clearly than does X-ray computed tomography (CT). In the present study, we compared MRI and/or CT of the brain in 3 cases with rheumatoid vasculitis to gauge their relative usefulness for detecting cerebrovascular damages in such patients. In one case with focal neurological symptoms (case 1), MRI depicted lesions responsible for the symptoms more clearly than did CT. In the other two cases (cases 2 and 3), which had no neurological nor psychiatric symptoms, MRI detected multiple microinfarcts in each brain; CT revealed no such lesions. These results indicate that MRI may be more useful than CT to detect brain lesions in patients with rheumatoid vasculitis, and that patients with rheumatoid vasculitis who show no CNS symptoms may in fact still have cerebrovascular lesions. Further studies with MRI in more patients with rheumatoid vasculitis should establish the incidence of cerebrovascular involvement such patients; it is probably much higher than has been previously reported.
Ishizuka
T
T
Department of Internal Medicine I, National Defense Medical College, Saitama.
Suzuki
K
K
Hara
M
M
Kitani
A
A
Kawagoe
M
M
Nakamura
H
H
Tsuchiya
K
K
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001927:Brain Diseases / Q000175:diagnosis* / Q000473:pathology; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D003711:Demyelinating Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged