[Characteristics of foci of increased MR signals in the brain of patients with systemic lupus erythematosus and cerebral involvement].
The frequency and size of MR hypersignal foci in the white and grey matter in T2 weighted images were evaluated in 50 patients with the definite diagnosis of systemic lupus erythematosus (SLE) with neuropsychiatric symptomatology (neuropsychiatric lupus--NPSLE) and in 50 healthy persons in this study. The lesions were divided according to the size to lesions smaller than 3 mm, lesions of 3-6 mm size and ones greater than 6 mm. Their total and relative number in the brain, the number in cerebral supra- and infratentorial regions and in all cerebral lobes was evaluated. Further their occurrence in the brain in the mediolateral and craniocaudal direction of MR investigation was determined. The study showed that the focal pathology manifests itself in NPSLE patients in 100% of cases with pronounced white matter predominance; the supratentorial occurrence of lesions and their subcortical localization significantly prevailed. As the lesions size is concerned in all patients, the lesions up to 3 mm significantly prevailed, lesions of 3-6 mm size were solitary and lesions greater than 6 mm were present up to 10% of cases. The significant predominance of all size lesions number in frontal and parietal lobes was observed in both groups of investigated persons. The statistically significant difference (p < 0.01) between both followed groups (SLE patients and controls) was found as in absolute and relative numbers of supratentorial lesions up to 3 mm, as in the total brain and in single cerebral lobes. The significant difference was recorded in the same parameters in 3-6 mm lesions and in ones greater than 6 mm. Lesions greater than 6 mm were never observed in controls. This specification of cerebral MR finding in NPSLE patients significantly supports the clinical diagnosis of NPSLE, even though it is not specific.
Peterová
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MR oddĕlení Radiodiagnostické kliniky, MR oddĕlení 1. lékarské fakulty Univerzity Karlovy a Vseobecné fakultní nemocnice, Katerínská 30, 120 00 Praha 2, Czech Republic. vpeterova@seznam.cz
Dostál
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D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged