Andrzej Lewszuk, Agnieszka Sulik, Stanisław Sierakowski, Jerzy Walecki, Eugeniusz Tarasów, Urszula ŁEbkowska
Med Sci Monit 2002; 8(6): MT105-111
BACKGROUND: Neurological complications in the course of SLE are mostlyassociated with vascular changes. An important role in their pathogenesis is played by immune mechanisms.The aim of the study was to determine the value of modern imaging techniques, with special referenceto selected MR sequences (FLAIR, DWI) in the diagnosis of cerebral changes in patients with neurologicalsymptoms of SLE.MATERIAL/METHODS: Fifty patients with neurological symptoms of SLE underwent CT and MRof CNS in routine sequences. In 12 cases EPI DWI sequences were also performed. Serum levels of antinuclear,anti-native DNA and antiphospholipid antibodies were also determined.RESULTS: The changes in CNS weredetected in 48 patients in MR and in 42 patients in CT. Focal changes were observed in 29 cases, whileatrophic changes were seen in the majority of subjects. In 10 cases, DWI showed changes typical for acutestroke. The extend and advancement of changes in CT and MR correlated with the severity of neurologicalsymptoms; there was also a correlation between the changes and elevated levels of antiphospholipid antibodies.FLAIR was useful in the detection of gliosis and cortical scar, while DWI enabled us to detect acuteischaemic foci and to distinguish them from coexistent scars.CONCLUSIONS: MRI with FLAIR and DWI sequencesenhances the sensitivity and specifity of neuroimaging techniques in the diagnosis of neuropsychiatricdisease in SLE. There is a correlation between elevated titre of antiphospholipid antibodies and thepresence of vascular changes in patients with neurological manifestations of SLE.
Keywords: Adult, Brain, Lupus Erythematosus, Systemic, Magnetic Resonance Imaging, Sensitivity and Specificity, Tomography, X-Ray Computed