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Published on: November 19, 2020
Perfusion MRI in neuro-psychiatric systemic lupus erthemathosus
Bart J Emmer1, Matthias J van Osch, Ona Wu
1Radiology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands. b.j.emmer@lumc.nl
Purpose:
To use perfusion weighted MR to quantify any perfusion abnormalities and to determine their contribution to neuropsychiatric (NP) involvement in systemic lupus erythematosus (SLE).
Materials And Methods:
We applied dynamic susceptibility contrast (DSC) perfusion MRI in 15 active NPSLE, 26 inactive NPSLE patients, and 11 control subjects. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps were reconstructed and regions of interest were compared between groups. In addition, the effect of SLE criteria, NPSLE syndromes, immunological coagulation disorder, and medication on CBF, CBV, and MTT was investigated.
Results:
No significant differences were found between the groups in CBF, CBV, and MTT. No significant influence of SLE criteria or NPSLE syndromes on CBF, CBV, or MTT was found. No significant influence of anti-cardiolipin antibodies, lupus anti-coagulant, the presence of anti-phospholipid syndrome (APS), or medication on CBF, CBV, or MTT was found.
Conclusion:
Our findings suggest CBF, CBV, and MTT in the white and the gray matter in SLE patients is not significantly different from healthy controls or between patients with and without specific symptoms or with and without immunological disorder involving coagulation.
Insights
Perfusion MRI revealed no significant differences in cerebral blood flow, volume, or transit time in patients with systemic lupus erythematosus (SLE), even with neuropsychiatric involvement or coagulation disorders.
Area of Science:
- Neuroimaging
- Rheumatology
- Neurology
Background:
- Systemic lupus erythematosus (SLE) can affect the central nervous system, leading to neuropsychiatric lupus (NPSLE).
- Perfusion abnormalities have been hypothesized to contribute to NPSLE.
- Quantifying perfusion changes is crucial for understanding SLE's neurological impact.
Purpose of the Study:
- To quantify perfusion abnormalities using perfusion-weighted MRI in SLE patients.
- To determine the contribution of these abnormalities to neuropsychiatric involvement in SLE.
- To investigate the relationship between perfusion parameters and clinical/immunological factors in SLE.
Main Methods:
- Dynamic susceptibility contrast (DSC) perfusion MRI was performed on 15 active NPSLE patients, 26 inactive NPSLE patients, and 11 controls.
- Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were calculated.
- Regions of interest were compared, and the influence of SLE criteria, NPSLE syndromes, coagulation disorders, and medication was analyzed.
Main Results:
- No significant differences in CBF, CBV, or MTT were observed between SLE patients and controls.
- No significant differences were found between active and inactive NPSLE patients.
- Clinical factors, immunological markers (including antiphospholipid antibodies), and medication did not significantly influence perfusion parameters.
Conclusions:
- Perfusion parameters (CBF, CBV, MTT) in white and gray matter do not differ significantly in SLE patients compared to controls.
- Specific NPSLE symptoms or coagulation disorders do not correlate with altered perfusion in SLE.
- Perfusion MRI may not be a sensitive tool for detecting abnormalities related to NPSLE or associated immunological conditions in SLE.
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