title: Brain MR findings in patients with systemic lupus erythematosus with and without antiphospholipid antibody syndrome.
abstract: OBJECTIVE
  Antiphospholipid syndrome may affect the incidence and pathogenesis of cerebrovascular diseases in patients with systemic lupus erythematosus. We compared the spectrum of MR findings in patients with systemic lupus erythematosus with and without antiphospholipid syndrome.
  
  
  METHODS
  We identified 256 patients with systemic lupus erythematosus (45 with, 211 without antiphospholipid syndrome) who underwent MR studies; in 145 (57%), we detected abnormalities. These were categorized as large territorial, lacunar, localized cortical, and borderzone infarctions and as microembolisms, basal ganglia lesions, callosal lesions, hemorrhages, and white matter hyperintensity on T2-weighted and/or FLAIR images, and as stenotic arterial lesions on MR angiograms. Logistic regression analysis was performed to compare the MR findings in patients with systemic lupus erythematosus with and without antiphospholipid syndrome, with patient age and antiphospholipid syndrome as the covariates.
  
  
  RESULTS
  Abnormal MR findings were more common in patients with systemic lupus erythematosus with antiphospholipid syndrome (73% versus 53%). Large territorial (P = .01), lacunar (P = .01), localized cortical (P < .01), borderzone infarcts (P < .01), basal ganglia lesions (P = .03), stenotic arterial lesions (P = .04), and the rate of positive findings on MR imaging (P = .01) were significantly associated with antiphospholipid syndrome. Irrespective of age, significantly more patients with antiphospholipid syndrome manifested lacunar infarcts in the deep white matter (P < .01), localized cortical infarcts in the territory of the MCA (P < .01), bilateral borderzone infarcts (P < .01), and anterior basal ganglia lesions (P = .01).
  
  
  CONCLUSIONS
  Abnormal MR findings were more common in patients with systemic lupus erythematosus with than in those without antiphospholipid syndrome. Large territorial infarctions, lacunar infarctions in the deep white matter, localized cortical infarctions in the MCA territory, bilateral borderzone infarctions, anterior basal ganglia lesions, and stenotic arterial lesions are common MR findings in patients with systemic lupus erythematosus with antiphospholipid syndrome.
authors.affiliation: Department of Radiology.
authors.forename: Y
authors.initials: Y
authors.lastname: Kaichi
authors.forename: S
authors.initials: S
authors.lastname: Kakeda
authors.forename: J
authors.initials: J
authors.lastname: Moriya
authors.forename: N
authors.initials: N
authors.lastname: Ohnari
authors.forename: K
authors.initials: K
authors.lastname: Saito
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: F
authors.initials: F
authors.lastname: Tatsugami
authors.forename: S
authors.initials: S
authors.lastname: Date
authors.forename: K
authors.initials: K
authors.lastname: Awai
authors.forename: Y
authors.initials: Y
authors.lastname: Korogi
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000150:complications* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity