神经精神性红斑狼疮的临床影像表现与预后的关系  

The relationship between imaging and clinical manifestations and prognosis of neuropsychiatric systemic lupus erythematosus

作　　者：连永伟[1] 王鸿章[1] 范伟雄[1] 俞万香[1] 

机构地区：[1]梅州市人民医院,广东梅州514031

出　　处：《热带医学杂志》2015年第7期950-952,共3页Journal of Tropical Medicine

摘　　要：目的探讨神经精神性红斑狼疮(NP-SLE)的脑部临床CT、MRI表现与预后的关系。方法回顾性分析50例病例的临床资料及CT、MRI表现,按临床表现分为弥漫型和局灶型,分析不同类型的影像学特点及其预后。结果 NPSLE的CT、MRI表现多样:脱髓鞘样改变,大片脑梗塞,腔隙性脑梗塞,脑出血,脑炎样改变,脑萎缩。其中弥漫型的影像学表现多为正常;腔隙性脑梗塞、脱髓鞘样改变,其预后较好;局灶型的影像学表现多为大片脑梗塞、脑出血、脑炎样改变,其预后较差。MRI和CT的检出率、弥漫型和局灶型治疗有效率差异均有统计学意义(P<0.05)。结论系统性红斑狼疮脑病CT、MRI表现多样,与临床表现类型以及预后密切相关。影像学检查不仅可发现病变,还可帮助评估治疗效果。Objective To discuss the relationship between the brain CT, MRI clinical manifestations and prognosis in neuropsychiatric systemic lupus erythematosus （NP-SLE）. Methods 50 cases of NP-SLE were divided into diffuse type and focal type according to their clinical features and analyzed retrospectively for the relationship between CT images and prognosis. Results CT and MRI features of NP-SLE were diversed ： demyelination ; large cerebral infarction ; lacunar cerebral infarction; cerebral hemorrhage ; encephalitis like change ; the brain atrophy. The main imaging findings of diffuse type usually normal, lacunar infarction and demyelination, and the prognosis is good ; for the focal type the imaging was mainly large cerebral infarction, cerebral hemorrhage and encephalitis like change, and the prognosis is poor. There were significant differences of MRI and CT detection rates and the effective rates of treatment in diffuse type and focal type （P〈0.05）. Conclusion The CT and MRI features of systemic lupus erythematosus encephalopathy are very diverse and are correlated with the clinical manifestations of diffuse type and focal types and their prognosis. CT examination not only can detect the lesions and also can help to evaluate the therapeutic effect.

关 键 词：系统性红斑狼疮 脑病 磁共振成像 体层摄像术 X线计算机 

分 类 号：R593.241[医药卫生—内科学]