title: Repeated brain conventional MRI and SPECT evaluation in systemic lupus erythematosus patients with and without neuropsychiatric involvement: a follow up study.
abstract: OBJECTIVE
  To assess the utility of a combined neuroimaging approach in the follow up of patients affected by systemic lupus erythematosus (SLE) with and without neuropsychiatric (NP) involvement.
  
  
  METHODS
  Patients who underwent a first combined brain conventional magnetic resonance imaging (cMRI) and single photon emission computed tomography (SPECT) and later repeated the same examinations between 2001 and 2008 were retrieved from a large database. Clinical and neuroimaging data were analysed and their relationships evaluated at baseline and at follow up.
  
  
  RESULTS
  Fifty SLE patients (38 with and 12 without NP involvement, mean age 36.8 yrs and mean disease duration at first instrumental evaluation 5.5 yrs) were enrolled. At baseline, the majority of them had a diffuse pattern of NP involvement. After a mean follow up period of 4 years all patients repeated neuroimaging and clinical evaluation. In 23 patients (22 with and 1 without NP manifestations at baseline) a new NP event occurred. Overall, neuroimaging remained unchanged or improved, but in some cases it worsened. No correlations were found between instrumental findings and clinical picture.
  
  
  CONCLUSIONS
  In this study, the clinical features at baseline appeared to be a better predictor of future NP events than morphological and functional neuroimaging. Therefore the utility of repeating a combined instrumental evaluation (cMRI and SPECT) may be debatable especially for patients with diffuse NP involvement where the decision to perform serial combined neuroimaging examinations should be carefully assessed and based mainly on clinical judgement.
authors.affiliation: Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Ferrara and Azienda Ospedaliero-Universitaria S. Anna, Italy. gabriella_castellino@yahoo.it
authors.forename: G
authors.initials: G
authors.lastname: Castellino
authors.forename: A
authors.initials: A
authors.lastname: Bortoluzzi
authors.forename: M
authors.initials: M
authors.lastname: Padovan
authors.forename: M
authors.initials: M
authors.lastname: Borrelli
authors.forename: L
authors.initials: L
authors.lastname: Feggi
authors.forename: M
authors.initials: M
authors.lastname: Govoni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D055815:Young Adult