系统性红斑狼疮性脑病的MRI表现  

MRI Features of Neuropsychiatric Abnormalities in Systemic Lupus Erythematosus

作　　者：张成周[1] 张敬[1] 伊慧明[2] 李威[1] 王萍[3] 

机构地区：[1]天津医科大学总医院放射科,天津300052 [2]中国医学科学院血液病研究所 [3]天津市人民医院

出　　处：《实用放射学杂志》2010年第4期466-469,共4页Journal of Practical Radiology

摘　　要：目的探讨系统性红斑狼疮性脑病（NPSLE）的MRI特点。方法回顾性分析21例经临床证实的NPSLE患者颅脑MRI图像，根据其DWI行ADC图重建，测量病灶及正常脑组织的ADC值并进行对照。结果21例NPSLE患者中颅脑MRI检查发现异常者20例，阳性率为95％。MRI异常表现包括：（1）DWI高信号14例，11例多发，3例单发；14例中4例合并脑萎缩；病灶部位皮层下白质较皮层多见；皮层DWI高信号病灶ADC值减低（t=2．513，P=0．019），白质DWI高信号病灶ADC值升高（t=2．877，P=0．007）。（2）单纯脑萎缩2例。（3）脑白质稀疏2例。（4）软化灶2例，其中1例合并脑萎缩。（5）5例NPSLE行MRI增强检查，2例强化，表现为沿脑回分布的条状、小片状强化。结论MRI在判断NPSLE脑部病变的有无、部位、进展及转归中起重要作用。Objective To evaluate the MRI features of neuropsychiatric abnormalities in systemic lupus erythematosus （NPSLE）. Methods Brain MRI images of 21 cases with NPSLE confirmed by clinic were analyzed retrospectively. ADC values of the lesions and normal brain tissue were measured. Results Brain abnormal MRI findings in 20/21 cases were found（95 %） including： （1） High signal intensity on DWI in 14 cases, 11 were diffuse lesions, 3 were focal lesions,4 of 14 combined with brain atrophy. The lesions mostly localized in white matter. The ADC values of the lesions in gray matter were decreased（t= 2.513, P=0. 019）, while the ADC values of the lesions in white matter were increased（t=2. 877,P=0. 007 ）. （2） 2 cases only showed brain atrophy. （ 3）Leukoaraiosis presented in 2 cases. （4）Encephalomalacie presented in 2 cases, 1 accompanied with brain atrophy. （5） No enhancement （3/5） and little patchy enhancement （2/5） were observed at contrast MRI study. Conclusion MRI plays an important role in displaying cerebral lesions and the location of it, progression and succession of NPSLE.

关 键 词：系统性红斑狼疮 脑 磁共振成像 

分 类 号：R593.241[医药卫生—内科学] R742[医药卫生—临床医学]