title: Detection of cerebral microvascular lesions using 7 T MRI in patients with neuropsychiatric systemic lupus erythematosus.
abstract: Neuropsychiatric systemic lupus erythematosus (NPSLE) is speculated to be caused by disturbed microcirculation of the central nervous system. However, characteristic imaging findings of NPSLE have not been established. Hence, we investigated whether high-resolution images obtained using ultrahigh field MRI at 7 T can detect microcerebrovascular lesions in patients with NPSLE that have never been detected by conventional MRI. We prospectively examined 20 patients with SLE, including five with NPSLE, using a 7 T MRI scanner. High-resolution two-dimensional T2-weighted images and high-resolution three-dimensional T1-weighted images (T1WIs) before and after the administration of contrast agents were obtained. On the high-resolution T1WIs obtained at 7 T, minute punctate/linear hyperintense lesions in subcortical and/or cortical areas were found in four (80%) NPSLE patients and one (7%) non-NPSLE patient. Further, the minute punctate enhanced lesions in these areas were found on contrast-enhanced T1WIs in only three (60%) NPSLE patients. These findings suggesting microvascular thrombi or inflammation were significantly more frequent in NPSLE than in non-NPSLE patients (P=0.001). In contrast, other imaging findings, laboratory findings, and clinical characteristics were not different between the two groups. High-resolution T1WIs obtained at 7 T can detect minute lesions, indicating intracerebral microvascular lesions in patients with NPSLE.
authors.affiliation: aDepartment of Internal Medicine, Division of Pulmonary Medicine, Allergy, and Rheumatology, Iwate Medical University School of Medicine, Morioka bDivision of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Japan.
authors.forename: Okinori
authors.initials: O
authors.lastname: Murata
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Sasaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Koko
authors.initials: K
authors.lastname: Kowada
authors.forename: Yukari
authors.initials: Y
authors.lastname: Ninomiya
authors.forename: Yuka
authors.initials: Y
authors.lastname: Oikawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Kohei
authors.initials: K
authors.lastname: Yamauchi
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D020945:Lupus Vasculitis, Central Nervous System / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D055815:Young Adult
chemical_list: D003287:Contrast Media