[The evaluation of neuropsychiatric lupus erythematosus by functional neuroimaging. Preliminary results].
OBJECTIVE
The aim of this study was to investigate the performance of functional neuro-imaging for describe neurological involvement in Lupus Erithematosus Systemicus.


METHODS
20 SLE patients were included into this study (18 females / 2 males). Median age was 40.5 years (range 16 -66 ys), 9 patients with a clear neurological involvement, 7 with aspecific neurological symptoms and 4 were asymptomatics, according to 1999 ACR Classification. All patients were underwent to conventional resonance imaging (RM-FLAIR), RM perfusion ( RM-PWI), RM diffusion (RM-DWI) and cerebral SPECT. The RM techniques was performed using a 1 Tesla "Signa-Horizon" Tomograph by General Electric: The data analysis was performed from two independent neuroradiologist and than trough coordinated evaluation after coregistration of acquired volumes.


RESULTS
In 11/20 patients (55%) lesions were demonstrated in RM-FLAIR evaluation, more frequent in cases with focal symptoms than in diffuse. RM-PWI was positive in 50% of cases. SPECT analysis was altered in 85 % of patients. In all patients RM-DWI evaluation was negative. 5 of 29 lesional areas (3 patients) showed by SPECT analysis were positive in RM-PWI. None of them was positive in RM-FLAIR study. After coordinated evaluation of RM-FLAIR, SPECT and RM-PWI, 7 findings were considered false positive. 6 Of patients with negative RM-FLAIR were positive in SPECT and 3 in RM-PWI. Only 1 patient was positive in SPECT and RM-PWI.


CONCLUSIONS
According to the literature, the RM-FLAIR is a very sensitive procedure to describe the lesional charge, especially in patients with focal symptoms. All lesions was considered as stable outcomes due to negativity of RM-DWI analysis. The SPECT is a sensitive technique to individuate cerebral areas of altered perfusion. The coregistration seems to be an helpful method to improve the explanation of uncertain cases. e the sections are prepared for the microscopic analysis of the various histomorphometric parameters.
Padovan
M
M
Cattedra e Unità Operativa di Reumatologia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Ferrara. melipadovan@yahoo.it
Locaputo
A
A
Rizzo
N
N
Govoni
M
M
Trotta
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon