MRI study of cerebral lesions and analysis of laboratory examination and prognosis of patients with neuropsychiatric systemic lupus erythematosus / 中华风湿病学杂志

ABSTRACT

Objective To investigate the magnetic resonance imaging (MRI) characteristics of cerebral lesions,laboratory data and prognosis of patients with neuropsychiatric systemic lupus erythematosus (NPSLE) and evaluate the correlation of MRI findings,autoantibodies and prognosis of NPSLE.Methods Thirty-one patients with NPSLE admitted during Jan 1998 to Oct 2011 were enrolled into this study,including 2 males and 29 females.MRI characteristics of cerebral lesions,laboratory data and clinical outcomes were retrospectively analyzed.x2-test and Spearman's correlation were used for statistical analysis.Results Cranial MRI scans on admission were abnormal in 27 (87％) of the 31 patients,among which 17 cases showed diffuse manifestations,9 cases showed focal lesions in brain and 1 case showed brain atrophy.The percentage of cases with focal lesions in the dead group (86％) was significantly higher than that of the survival group (13％) (P＜0.01),while the percentage of diffuse lesion cases was significantly lower in dead group (P＜0.01).Although the mean lesion numbers in the dead group were fewer compared with the survival group,lesion numbers in brainstem (18％) (P＜0.01) or basal ganglia (29％) (P＜0.05) were much more in the dead group.The positive rate of anti-ribosomal P protein antibodies shown in the dead group (43％) was markedly higher than that in the survival group (29％) (P＜0.05).The positive rates of ACL in cases with diffuse lesions and cases with focal lesion were higher compared with cases showing normal MR images (P＜0.01).Furthermore,the positive rate of anticardiolipin antibodies (ACL) in cases with focal lesions (56％) were higher than cases with diffuse lesion (35％) (P＜0.05).There was no correlation between the seven types of autoantibodies and lesion locations such as basal ganglia,subcortical white matter,anterior and posterior horn of lateral ventricle,semiovale center,cerebral cortex,brainstem and cerebellum.Conclusion MRI findings and autoantibodies are correlated in patients with NPSLE and both of them may be used as prognostic markers for NPSLE.Focal lesions,location of brainstem and basal ganglia on cranial MR images,positive anti-ribosomal P protein antibody may predict an unfavorable clinical outcome of NPSLE; however,the correlation between ACL and prognosis could not be determined.