Systemic lupus erythematosus: prediction by MRI of the subsequent development of brain lesions.
OBJECTIVE
Many patients with systemic lupus erythematosus (SLE) manifest the recurrence of new brain lesions on follow-up magnetic resonance imaging (MRI) scans. We assessed whether the initial MRI findings help to predict the subsequent development of brain lesions in patients with SLE.


METHODS
We enrolled 64 patients with SLE who had undergone initial and follow-up MRI studies. Two radiologists reviewed and categorized the initial MRI findings and divided the patients into those with no lesions on the initial and follow-up MRI scans (group A, n = 18), those with lesions on the initial scans only (group B, n = 32), and those with lesions on the first and new lesions on the follow-up MRI scans (group C, n = 14). We then looked for independent predictors of the subsequent development of brain lesions, such as antiphospholipid syndrome (APS) and findings on the initial MRI studies.


RESULTS
The incidence of lacunar and localized cortical infarcts was significantly greater in group C than group B (50% vs. 0%, P < .001 and 50% vs. 9%, P < .05, respectively). Multivariate logistic regression analysis indicated that lacunar or localized cortical infarcts on the initial MRI scans were independent predictors of the subsequent development of brain lesions (odds ratio [OR]: 5.412, 95% confidence interval [CI]: 1.18-24.85, P = .03), whereas the presence of APS was not (OR: 0.621, 95% CI: 0.18-2.19).


CONCLUSIONS
The presence of lacunar and/or localized cortical infarcts on initial MRI scans may predict the development of new brain lesions in patients with SLE.
Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Koichiro
K
Futatsuya
Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan. Electronic address: kakeda@med.uoeh-u.ac.jp.
Shingo
S
Kakeda
Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Yoko
Y
Kaichi
Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Junji
J
Moriya
Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Norihiro
N
Ohnari
Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
Kazuyoshi
K
Saito
Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
Yoshiya
Y
Tanaka
Department of Radiology, University of Occupational and Environmental Health, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Yukunori
Y
Korogi
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D055815:Young Adult
MRI; Systemic lupus erythematosus; antiphospholipid syndrome; brain; neuropsychiatric systemic lupus erythematosus; prediction