神经精神性系统性红斑狼疮的MRI表现与临床分析

目的:探讨神经精神性系统性红斑狼疮(NPSLE)的MRI表现及其临床表现与预后间的关系。方法:回顾性分析经临床证实的24例NPSLE的临床资料及MRI表现,按临床表现分为弥漫型和局灶型,分析不同类型的MRI表现特点及与预后间的关系。结果:20例MRI检查有异常,对病变的检出率为83.33%。NPSLE的MRI表现多样,主要表现为脑部皮层下斑点状和片状病灶、脑梗死、出血、基底节区片状病灶、桥脑中央髓鞘溶解症和脑萎缩。其中弥漫型的影像学表现多为正常、腔隙性脑梗死、脱髓鞘样改变,其预后较好;局灶型影像学表现多为大片脑梗死、脑出血、脑炎样改变,其预后较差。结论:NPSLE的MRI表现多样,MRI对NPSLE病变显示敏感,对其早期诊断、指导治疗、判断疗效和提示预后具有重要价值。

MRI Findings and Clinical Study of Neuropsychiatric Systemic Lupus Erythemaosus

Objective To study the correlations MRI findings and clinical features,prognosis in NPSLE. Methods A prospective study was conducted on 24 cases verified by clinic, which were classified as local and diffuse by clinical feature. Resuits of the 24 cases, there were 20 cases with abnormal MR appearances. The main MRI findings of NPSLE included subcortical focal and diffuse lesions, infarcts, hemorrhage, symmetrical diffuse lesions in bilateral ganglions, central pontine myelinolysis and cerebral atrophy. The main imaging findings of diffuse NPSLE which is good prognosis were normality, lacunar infarct, demyelination; The main imaging findings of local NPSLE which is bad prognosis were large patihes cerebral infarct, cerebral hemorrhage, encephalitis. Conclusion The MRI findings of NPSLE is multiple. MRI is very sensitive in detecting CNS involvemeut in NPSLE. It is of great value in making early diagnosis of NPSLE, in directing climical managemrnt, in judying therapeutic effect and in predicting the proynosis.