Authors: Hae Woong Jeong Minyoung Her Jong Seok Bae SeongKyu Kim Sung Won Lee Ho Kyun Kim Dongyook Kim Nayoung Park Won Tae Chung Sang Yeob Lee JungYoon Choe In Joo Kim
Publish Date: 2014/10/15
Volume: 35, Issue: 5, Pages: 861-869
Abstract
The purpose of this study was to identify the characteristic magnetic resonance imaging MRI findings in neuropsychiatric systemic lupus erythematosus NPSLE and to investigate the association between MRI findings and neuropsychiatric manifestations in SLE Brain MRIs with a diagnosis of SLE from 2002 to 2013 from three tertiary university hospitals were screened All clinical manifestations evaluated by brain MRI were retrospectively reviewed If the clinical manifestations were compatible with the 1999 NPSLE American College of Rheumatology ACR nomenclature and case definitions the brain MRIs were assessed for the presence of white matter hyperintensities gray matter hyperintensities parenchymal defects atrophy enhancement and abnormalities in diffusionweighted images DWI The number size and location of each lesion were evaluated The neuropsychiatric manifestation of each brain MRI was classified according to the 1999 ACR NPSLE case definitions The associations between MRI findings and NPSLE manifestations were examined In total 219 brain MRIs with a diagnosis of SLE were screened and 133 brain MRIs met the inclusion criteria for NPSLE The most common MRI abnormality was white matter hyperintensities which were observed in 76 MRIs 571 Gray matter hyperintensities were observed in 41 MRIs 308 Parenchymal defects were found in 31 MRIs 233 and atrophy was detected in 20 MRIs 150 Patients who had seizures were more associated with gray matter hyperintensities than patients with other neuropsychiatric manifestations Patients with cerebrovascular disease were more associated with gray matter hyperintensity parenchymal defects and abnormal DWI than patients with other neuropsychiatric manifestations In addition to white matter hyperintensities which were previously known as SLE findings we also noted the presence of gray matter hyperintensities parenchymal defects and abnormal DWI in a substantial portion of SLE patients particularly in those with cerebrovascular disease or seizures
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