【摘要】 目的 探討系統(tǒng)性紅斑狼瘡腦?。⊿LEE）的磁共振成像（MRI）特征和診斷價值。 方法 回顧性分析2007年1月-2009年7月間18例SLEE的臨床表現(xiàn)及MRI特征。 結(jié)果 18例患者M(jìn)RI檢查的顱腦陽性率為88.88%（16/18），腦部MRI表現(xiàn)為:①15例為多發(fā)病灶，局灶者1例。②雙側(cè)大腦半球、基底節(jié)區(qū)及小腦半球腦實質(zhì)內(nèi)長T1、長或稍長T信號，DWI及EPI成像上呈高或稍高信號，灰白質(zhì)均可受累，分布無規(guī)律性。③增強MRI掃描9例，其中5例呈斑片狀強化，4例無明顯強化。④腦梗死12例，腦出血4例。合并腦水腫9例，腦萎縮7例。 結(jié)論 SLEE的MRI表現(xiàn)多樣，結(jié)合臨床資料，MRI可以作出診斷。
【Abstract】 Objective To investigate the magnetic resonance imaging (MRI) features of systemic lupus erythematosus encephalopathy (SLEE) and its diagnostic value. Methods The clinical data and MRI images of 18 patients with SLEE admitted from January 2007 to July 2009 in our hospital were analyzed retrospectively. Results Positive findings were found in 16 patients (88.88%). MRI findings of SLEE were the following: ①A Total of 15 patients were with diffuse lesions, one patient was with focal lesions. ②Cerebral hemisphere involvement and bilateral caudate long T1 and long or slightly long T2 signal were intensive in the brain parenchyma, and appeared as hyper-intensity or slightly hyper-intensity on DWI and EPI. Grey and white matters were involved often and irregularly distributed. ③The results of 9 patients by enhanced MRI showed that 5 patients were with patchy enhancement and 4 were without enhancement. ④Of the 16 positive patients, 12 were with cerebral infarction and 4 with cerebral hemorrhage, while 9 patients were complicated with cerebral edema, and 7 patients were with cerebral atrophy. Conclusion MRI manifestations of SLEE are various. Combined with clinical data, MRI can diagnose SLEE exactly.
引用本文： 賓精文,孫玉林,布桂林,楊鴻. 系統(tǒng)性紅斑狼瘡腦病的MRI診斷. 華西醫(yī)學(xué), 2010, 25(7): 1286-1288. doi: 復(fù)制
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- 1. 周滟, 許建榮. 系統(tǒng)性紅斑狼瘡神經(jīng)系統(tǒng)病變的影像學(xué)表現(xiàn)[J]. 國外醫(yī)學(xué)臨床放射學(xué)分冊, 2002, 25(4): 225-227.
- 2. Mok CC, Mak A, Tsui EY. Shrinking central nervous system in systemic lupus erythematosus[J]. Ann Rheum Dis, 2004, 63(5): 603-604.
- 3. 黃勁柏, 徐海波, 孔祥泉, 等. 神經(jīng)精神性系統(tǒng)性紅斑狼瘡的磁共振表現(xiàn)[J]. 實用放射學(xué)雜志, 2007, 23(5): 584-586.
- 4. 王新得. 全身疾病的神經(jīng)系統(tǒng)表現(xiàn)[M]. 北京: 人民軍醫(yī)出版社, 2001: 194-196.
- 5. Calamia KT, Balabanove M. Vasculitis in systemic lupus erythematosus[J]. Clin Dermol, 2004, 22(2): 148-156.
- 6. Kelly RE. CNS vasculitis[J]. Front Biosci, 2004, 11(9): 946-955.
- 7. Tomita M, Khun DL, Blehm BH, et al. The potential pathogenetic link between peripheral immune activation and the central innate immune response in neuropsychiatric systemic lupus erythematosus[J]. Med Hypotheses, 2004, 62(3): 325-335.
- 8. Abbott NJ, Mendonca LI, Dolman DE. The blood-brain barrier in systemic lupus erythematosus[J]. Lupus, 2003, 12(12): 908-915.
- 9. 張惠龍, 周東. 系統(tǒng)性紅斑狼瘡的神經(jīng)精神表現(xiàn)[J]. 國外醫(yī)學(xué)神經(jīng)病學(xué)神經(jīng)外科學(xué)分冊, 2003, 30(2): 144-146.
- 10. Govoi M, Castellino G, Padovan M, et al. Recent advances and future perspective in neuroimaging in neuropsychiatric systemic lupus erythematosus[J]. Lupus, 2004, 13(3): 149-158. .