Systemic lupus erythematosus: brain MR imaging and single-voxel hydrogen 1 MR spectroscopy

To evaluate the usefulness of magnetic resonance (MR) imaging and hydrogen 1 MR spectroscopy in the detection of brain involvement in patients with systemic lupus erythematosus (SLE) with or without neuropsychiatric symptoms.

Twenty-six patients who had SLE with (n = 17) or without (n = 9) neuropsychiatric symptoms were examined at MR imaging and (1)H MR spectroscopy. The voxel was placed in the basal ganglia and peritrigonal white matter. Eight healthy volunteers were included.

Five of nine patients with major neuropsychiatric symptoms and one of eight patients with minor neuropsychiatric symptoms had abnormal MR imaging findings. (1)H MR spectroscopy showed a significantly decreased N:-acetylaspartate-creatine (Cr) ratio in the basal ganglia and an increased choline-Cr ratio in the peritrigonal white matter in patients with major symptoms compared with those with minor symptoms, those without symptoms, and healthy control subjects. Among patients with major symptoms, there was no difference in metabolite ratios between those with and those without abnormal MR imaging findings. Among patients with normal MR imaging findings, abnormal spectral changes were observed only in those with major neuropsychiatric symptoms. In patients without neuropsychiatric symptoms, results of (1)H MR spectroscopy and MR imaging were normal.

In patients with SLE, (1)H MR spectroscopic findings seem to reflect the cerebral metabolic disturbance related to the severity of the neuropsychiatric symptoms and are not related to the presence of abnormal MR imaging findings.