title: Perfusion-weighted MR imaging in cerebral lupus erythematosus.
abstract: OBJECTIVE
  Neuropsychiatric systemic lupus erythematosus (NPSLE) is a diagnostically challenging, severe, and life-threatening condition, which is currently lacking a "gold standard." Our aim with this study is to look for magnetic resonance (MR) perfusion differences in NPSLE, SLE, and healthy control (HC) patients and correlate our findings with clinical parameters.
  
  
  METHODS
  Twenty-four NPSLE patients, 21 SLE patients, and 21 HC underwent dynamic susceptibility contrast enhanced MR perfusion using a 3-T scanner. Nine prospectively selected intracranial regions of interest were placed in white and gray matter and the cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) values were calculated. Subjects underwent clinical evaluation with SLEDAI and serum antibodies.
  
  
  RESULTS
  The SLE patients had higher CBF and CBV compared to the HC overall (P = .01) and in specific areas (P = .03-.048). SLE patients with signs of active disease (elevated SLEDAI and anti-double-stranded DNA) had significantly elevated CBV, CBF, and MTT in the posterior cingulate gyrus (P = .01-.02). No significant difference was seen in the magnetic resonance perfusion measurements of NPSLE patients compared to SLE and HC, although the NPSLE patients also showed higher CBV variability compared to the SLE (P = .0004) and HC cohort (P < .0001).
  
  
  CONCLUSIONS
  SLE patients have increased CBV and CBF compared to healthy controls. The SLE patients with clinical markers for active disease have elevated CBV, CBF, and MTT in the posterior cingulate gyrus. NPSLE patients show increased variability in perfusion measurements, which may explain why susceptibility contrast enhanced MRI has not yet provided a specific target for NPSLE.
authors.affiliation: Department of Diagnostic Radiology, University of Michigan Hospital, Ann Arbor, 48109-5030, USA. pagew@umich.edu
authors.forename: Page I
authors.initials: PI
authors.lastname: Wang
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Cagnoli
authors.forename: William J
authors.initials: WJ
authors.lastname: McCune
authors.forename: Tobias
authors.initials: T
authors.lastname: Schmidt-Wilcke
authors.forename: Suzan E
authors.initials: SE
authors.lastname: Lowe
authors.forename: Courtney C
authors.initials: CC
authors.lastname: Graft
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Gebarski
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Chenevert
authors.forename: Shokoufeh
authors.initials: S
authors.lastname: Khalatbari
authors.forename: James D
authors.initials: JD
authors.lastname: Myles
authors.forename: Kuanwong
authors.initials: K
authors.lastname: Watcharotone
authors.forename: Paul
authors.initials: P
authors.lastname: Cronin
authors.forename: Pia C
authors.initials: PC
authors.lastname: Sundgren
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000473:pathology*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity