title: [The value of brain magnetic resonance imaging in the early diagnosis of neuropsychiatric systemic lupus erythematosus].
abstract: OBJECTIVE
  To investigate the value of brain magnetic resonance imaging (MRI) in evaluating the intracranial injuries in patients with juvenile onset systemic lupus erythematosus (SLE).
  
  
  METHODS
  Data of brain MRI, CT, electroencephalogram (EEG), cerebrospinal fluids analysis and clinical features of the central nervous system of 44 patients from March 2007 to March 2015 with juvenile onset SLE who were not treated with glucocorticoids (Gcs) and immunosuppressive agents (Is) were retrospectively analyzed and compared.
  
  
  RESULTS
  Twenty-seven out of 44 patients demonstrated abnormal signs on brain MRI, including encephalatrophy, cerebral infarction, demyelination, encephalorrhagia, vertebral arteriostenosis and abnormal signals on the brain diffusion-weighted imaging (DWI). Sixteen patients had clinical features of the central nervous system involvement, fifteen had continuous headache, nine had continuous dizziness, seven had convulsions, three had hemiplegia, one had blurred vision. Physical examination of the nervous system: ten patients had abnormal signs, all had cervical rigidity, five showed pyramidal sign, three showed loss of muscle tone, two with cranial neuropathies and one had paresthesia. EEG: Ten patients showed abnormal waves on EEG, all showed diffused slow-waves, and five showed sharp waves and spikes. Cerebrospinal fluids analysis: six patients had abnormal results, five of them had cell count elevation and one had cell count and protein elevation, while there was glucose and chloride degression. Brain CT: Eight patients received CT scan, two showed cerebral infarction. χ(2) test was used to compare the differences among head MRI, EEG, cerebrospinal fluid analysis, physical examination of the nervous system, clinical features of the nervous system, the difference was significant(χ(2)=12.055, P=0.001; χ(2)=19.627, P=0.001; χ(2)=3.859, P=0.049; χ(2)=12.055, P=0.001).
  
  
  CONCLUSIONS
  Brain MRI may be a better method in early diagnosis of intracranial injuries than CT, EEG, cerebrospinal fluid analysis and physical examination of the nervous system. Patients with juvenile onset SLE should receive brain MRI after diagnosis in order to investigate the intracranial injuries. Abnormal signals on the DWI are the signs of active disease.
authors.affiliation: Department of Rheumatology and Immunology, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China.
authors.forename: J M
authors.initials: JM
authors.lastname: Lai
authors.forename: F Q
authors.initials: FQ
authors.lastname: Wu
authors.forename: Z X
authors.initials: ZX
authors.lastname: Zhou
authors.forename: Y C
authors.initials: YC
authors.lastname: Yan
authors.forename: G X
authors.initials: GX
authors.lastname: Su
authors.forename: S N
authors.initials: SN
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Zhu
authors.forename: M
authors.initials: M
authors.lastname: Kang
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction; D003389:Cranial Nerve Diseases; D038524:Diffusion Magnetic Resonance Imaging; D042241:Early Diagnosis; D004569:Electroencephalography; D006261:Headache; D006801:Humans; D020945:Lupus Vasculitis, Central Nervous System / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012640:Seizures