系统性红斑狼疮患者脑小血管病变的MRI初步研究

目的:应用MRI常规序列对系统性红斑狼疮(SLE)患者脑内血管周围间隙扩大(EPVS)、白质高信号(WMH)及腔隙灶进行评估,初步分析SLE患者脑小血管病变的MRI表现。材料与方法:回顾性收集29例SLE患者及29例年龄、性别与SLE组相匹配的健康体检者作为对照组。通过观察EPVS、WMH及腔隙灶的情况,对其进行相应的分级及评分。并记录SLE患者临床及化验室检查指标。应用SPSS 24.0版统计软件进行数据分析,等级资料用Kolmogorov-Smirnov Z检验分析组间差异,应用Spearman相关分析法分析EPVS、WMH及腔隙灶与临床、实验室检查之间的相关性。结果:在半卵圆中心,SLE组的EPVS评分(2.52±0.91)显著高于对照组(1.34±0.55,P<0.01);SLE组脑室周围白质高信号(PVH)和深部脑白质高信号(DWMH)均较对照组更明显(P<0.01);SLE组腔隙灶的发生率高于对照组(P<0.05)。并且半卵圆中心EPVS及PVH与补体C3相关(r=0.505,0.400,P均<0.05);EPVS和WMH与病程呈正相关(r=0.460、0.428、0.416、0.404,P均<0.05)。结论:脑小血管病变是SLE中枢神经系统病变的常见表现,并与补体C3及病程具有关联性。

MRI findings of cerebral small vessel disease in patients with systemic lupus erythematosus

Objective:To evaluate MRI findings of enlarged perivascular space(EPVS),white matter hyperintense(WMH)and lacunes of cerebral small vessel disease(CSVD)in patients with systemic lupus erythematosus(SLE).Materials and Methods:Twenty-nine SLE patients and twenty-nine age-and sex-matched healthy subjects participated in this retrospective study.EPVS,WMH,and lacunes were rated by two radiologists.SPSS 24.0 was used for data statistical analysis,Kolmogorov-Smirnov Z test was used to analyze group difference,and Spearman correlation analysis was used to analyze the correlation between CSVD and clinical and laboratory examination.Results:In the centrum semiovale(CS),the EPVS score in the SLE group was higher than that in the control group(2.52±0.91,1.34±0.55,P<0.01).The periventricular hyperintense(PVH)and deep white matter hyperintense(DWMH)in the SLE group were more significant than those in the control group(P<0.01),and the incidence of lacunes in SLE group was higher than that in the control group(P<0.05).In SLE group,EPVS in the CS and PVH were correlated with complement C3(r=0.505,0.400,P<0.05),EPVS score and WMH were positively correlated with disease duration(r=0.460,0.428,0.416,0.404,P<0.05).Conclusion:Cerebral small vessel disease is a common manifestation of central nervous system lesions in SLE patients and is associated with complement C3 and disease duration.