Multisequence magnetic resonance imaging study of neuropsychiatric systemic lupus erythematosus.
OBJECTIVE
To investigate the relationship between magnetization transfer imaging (MTI), diffusion-weighted imaging (DWI), proton magnetic resonance spectroscopy (H-MRS), and T2 relaxometry findings in patients with primary neuropsychiatric systemic lupus erythematosus (NPSLE).


METHODS
The study group consisted of 24 female patients (mean age 36 years [range 23-65]) who had had a variety of neuropsychiatric symptoms that were judged to be due to NPSLE according to the criteria of the American College of Rheumatology. Patients with current active disease were excluded from participation. Quantitative MTI, DWI, H-MRS, and T2 relaxometry data were acquired in all patients, and the correlation coefficients were calculated.


RESULTS
MTI results reflecting a decrease in homogeneity of cerebral parenchyma correlated significantly with H-MRS results representing axonal damage. MTI results also correlated significantly with DWI results reflecting increased diffusivity in the cerebral parenchyma. Finally, MTI results reflecting decreased cerebral homogeneity correlated significantly with increased T2 relaxation time, associated with either edema or gliosis. Increased T2 relaxation time correlated significantly with DWI results reflecting increased diffusivity. With the exception of the correlation between H-MRS and MTI findings, there was no significant correlation between H-MRS results and any other parameter.


CONCLUSIONS
The selected study parameters represent different biologic features in the human brain and can be informative with regard to different pathologic processes in NPSLE. The demonstrated associations between MTI, DWI, H-MRS, and T2 data in patients with a history of NPSLE suggest that there is one pathogenesis and/or common neuropathologic outcome in NPSLE despite differences in clinical presentation.
Leiden University Medical Center, Leiden, The Netherlands. g.p.t.bosma@lumc.nl
G P Th
GP
Bosma
S C A
SC
Steens
Helen
H
Petropoulos
Faiza
F
Admiraal-Behloul
A
A
van den Haak
J
J
Doornbos
T W J
TW
Huizinga
William M
WM
Brooks
Aaron
A
Harville
Wilmer L
WL
Sibbitt
M A
MA
van Buchem
D000328:Adult; D000368:Aged; D001921:Brain / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged