神经精神性狼疮MRI检查的临床应用价值

目的：探讨神经精神性狼疮(NPSLE)MRI表现特点及其与临床的关系。方法：52例NPSLE患者在出现症状后1天～2个月内进行头部MR检查。另选取26例无神经系统症状的SLE患者和27例健康志愿者行MR检查并与NPSLE组比较。结果：NPSLE的MRI主要表现为斑点状和大片状脑炎样病变、出血、脑梗死和脑萎缩，额、顶叶和基底节区好发。表现为点状病灶的临床以精神障碍和头痛为主要表现，片状病灶以癫痫和偏瘫为主要表现。临床病情严重患者的片状病灶的发生率、病灶总面积较轻微组显著增高。片状的，边缘模糊的，T1WI等、略低信号，T2WI高信号的病灶变化迅速。结论：NPSLE的MRI检查有助于明确脑病性质及更准确的评估病情和预后，从而指导治疗和评价疗效。

Clinical application of MRI in patients with neuropsychiatric systemic lupus erythematosus

Objective:To study the MRI manifestations of neuropsychiatric systemic lupus erythematosus (NPSLE) in correlation with clinical condition.Methods:Fifty two patients who fulfilled the diagnostic criteria of NPSLE were stu died. MR imaging of the brain were performed within 1 day to 2 months after the onset of symptoms of encephalopathy,and the findings on MR imaging were analyzed combined with the clinical information.Other twenty six patients who fulfilled the diagnostic criteria of SLE without neurological or psychiatric symptoms and 27 normal volunteers were selected to perform MR imaging for comparison with the NPSLE.Results:The MRI features of NPSLE included focal and diffuse cephali tical lesions,hemorrhage,infarcts and atrophy.The lesions were usually found in frontal and parietal lobe and basal ganglion.The patients having focal lesions usually have headache and psychosis and those with seizure or hemiparalysis are usually found to have diffuse lesions.The patchy lesions and large extent of the lesion were seen more often in severe cases.The iso or hypo intensity on T 1WI,hyper intensity on T 2WI,blurry border and patchy lesions might change quickly from day to day.Conclusion:MR imaging of NPSLE can not only reveal the lesion's character and help evaluate the state and prognosis of the illness,but also be of importance in guiding the therapy and evaluating the response to treatment.