系统性红斑狼疮脑损害的CT诊断（附21例报告）

目的：通过21例系统性红斑狼疮（SLE）脑损害的CT分析，以提高对本病CT改变的认识及提高对本病的诊断水平。方法：选择按美国风湿病学会修订标准临床确诊的SLE并行头颅CT扫描，且有阳性改变的病人21例；其中17例有程度不同的神经精神症状；7例治疗后半年至年半后复查1－3次。结果：20列显示普遍性大脑皮质萎缩，其中5例合并脑白质萎缩。7例两侧脑白质为主多发性无强化低密度影。3例侧脑室壁或脑室旁脑白质各有1至3个小高密度钙化结节。1例侧脑室壁可疑小高密度影。1例治疗中出现脑出血。复查之7例在6－18个月后脑萎缩恢复正常或明显好转。结论：CT对SLE脑损害不仅能迅速诊断，而且给治疗和预后提供可靠依据。

CT diagnosis of the brain damage of the systemic lupus erythematosus(report of 21 cases)

The CT findings of 21 cases of the brain damge of the systemic lupus erythematosus (SLE) were analysed in order to improve recognition and diagnostic level. Methods Twenty one cases were selected from SLE by clinical diagnosis according to the criteria which was revised by the ARA( American Rheum Association)CT scan has been performed and abnormal CT findings were found In all cases, 17 of 21 had the nervous - mental symptoms in different degrees. One to three times of CT scans were performed in 7 eases within half a year to a year and a half after the treatment. Results 20 cases on CT images showed with atrophy of general cerebral cortex, 5 of the 20 cases accompanied with atrophy of cerebral white matter , Seven cases showed many unenhaneed hypodense lesions in cerebral white matter. There were one to three small calcifications in 3 caese in the lateral ventricles wall or cerebral white matter of the periventricular. There was a suspect small calcification in one case in the lateral ventricle wall. The intracerebral hemorrhage was found in one ease during the treatment, The atrophy were returned to normal or take a turn for the better obviously in seven cases in 6 to 18 months after treatment. Conclusion In the brain damage of SLE, CT can not only diagnose quickly but also provided reliable evidences for treatment and prognosis.