Brain magnetic resonance imaging findings in patients with systemic sclerosis.
BACKGROUND
Systemic sclerosis is a multisystem disease where functional and structural abnormalities of small blood vessels prevail. Recently, transient ischemic attacks, ischemic stroke, and hemorrhages have been reported as primary consequence of vascular central nervous system affection in systemic sclerosis. Magnetic resonance imaging (MRI) is considered to be the most sensitive diagnostic technique for detecting symptomatic and asymptomatic lesions in the brain in cases of multifocal diseases.


OBJECTIVE
Evaluate brain changes in patients with systemic sclerosis using MRI.


METHODS
Thirty female patients with systemic sclerosis aged 27-61 years, with disease duration of 1-9 years and with no history of other systemic disease or cerebrovascular accidents, were enrolled. An age-matched female control group of 30 clinically normal subjects, underwent brain MR examination.


RESULTS
Central nervous system involvement in the form of white matter hyperintense foci of variable sizes were found in significantly abundant forms in systemic sclerosis patients on MR evaluation than in the age-related control group, signifying a form of central nervous system vasculopathy. Such foci showed no definite correlation with disease duration, yet they showed significant correlation to severity of peripheral vascular disease, headaches, fainting attacks and depression in the group under study.


CONCLUSIONS
Asymptomatic as well as symptomatic central nervous system ischemic vasculopathy is not uncommon in systemic sclerosis patients and MRI is considered a sensitive noninvasive screening tool for early detection of CNS involvement in patients with systemic sclerosis.
Mohamed
Reem H A
RH
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Cairo University, Cairo, Egypt. rmhamdy@yahoo.com
Nassef
Amr A
AA
D000328:Adult; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011237:Predictive Value of Tests; D012595:Scleroderma, Systemic / Q000473:pathology*