系统性红斑狼疮脑病的MRI表现与临床分析

目的 研究系统性红斑狼疮脑病(NPSLE)患者的临床及磁共振成像(MRI)特点.方法 四顾性分析21例NPSLE患者的临床与MRI表现.结果 轻型4例,中型10例,重型7例.治疗后4例轻型,6例中型,2例重型患者病情好转;3例重型患者死亡；其他患者4例病情恶化,2例出院时无明显变化.MRI表现:大脑、小脑半球深部白质、基底节区及脑干异常病灶14例,其中2例有基底节区小灶性亚急性出血.病灶在T1WI上主要呈等、稍低信号,T2WI呈稍高信号,FLAIR序列为高信号,2例表现为沿脑回分布的条状、小片状强化.脑萎缩7例,脑白质稀疏2例.MRI检查阳性率为80.9％( 17/21).结论 NPSLE患者的临床及MRI表现多种多样,无特异性,MRI对NPSLE的早期诊断、指导治疗及评价疗效方面有重要意义,但对NPSLE的诊断必须结合临床病史及实验室检查.

MRI manifestations of neuropsychopathy in systemic lupus erythenmatosus and clinical analysis

Objective To study clinical and magnetic resonance imaging(MRI) characteristics in the patients with neuropsychopathy of systemic lupus erythenmatosus(NPSLE).Methods The clinical and MRI manifestations in 21 patients with NPSLE were retrospectively analyzed.Results The clinical manifestations were mild type in 4 cases,moderate type in 10 cases and severe type in 4 cases.After the treatment,4 cases of mild type,6 cases of moderate type and 2 cases of severe type got better;3 cases of severe type died.Among the other cases,4 cases deteriorated and 2 cases had no notable variation in the discharge from hospital.MR imaging manifestations concluded the abnormal focuses in deep white matter of cerebral and cerebellar hemisphere,basal ganglia area and brain stem in 14 cases.Among them,2 cases showed focal subacute hemorrhage in the basal ganglia.The lesion present as iso-or low-signal on T1WI,high-signal on T2WI and high-signal on the FLAIR sequence primarily.2 cases showed strip and platelet reinforcement spreading of gyrus.Cerebral atrophy was in 7 cases and leukoaraiosis was in 2 cases.The positive rate of MRI examination was 80.9%(17/21).Conclusion Clinical and MRI manifestations of NPESR are various without specificity.MRI has important significance for the early diagnosis,guiding treatment and effective evaluation of NPSLE.But the diagnosis of NPSLE must combined with the clinical medical history and laboratory examinations.