ABSTRACT
This study shows the contribution of MRI to diagnosis and follow up of the cerebral lesions in neuro-lupus. Ten cases of neuro-lupus have been reported. The affected patients are 7 women and 3 men having an average age of 34 years. For 8 patients, MRI revealed lesions that were not detected using computed tomography. These lesions were high signal zones on T2, scattered with predilection to deep and sub-cortical cerebral white matter. MRI has also shown cortical and sub-cortical cerebral atrophy for 3 cases, cortical and deep infarcts for 2 cases and both atrophy and infarcts in one case. The MRI diagnosis was normal for the two remaining patients. MRI contributes to the diagnosis confirmation and localization of the cerebral lesions and to the follow-up. In spite of MRI sensitivity, the detection of these lesions remains non specific to neuro-lupus. New methods of exploration as the spectroscopy by magnetic resonance and the cerebral scintigraphy with Technetium 99m could be very helpful in diagnosis of cases for which MRI has shown limitations.
Subject(s)
Lupus Vasculitis, Central Nervous System/diagnosis , Magnetic Resonance Imaging/standards , Adolescent , Adult , Aftercare , Child , Female , Humans , Male , Middle Aged , Radiopharmaceuticals , Reproducibility of Results , Retrospective Studies , Sensitivity and Specificity , Technetium Tc 99m Exametazime , Tomography, Emission-Computed, Single-Photon/standards , Tomography, X-Ray Computed/standardsABSTRACT
The authors report five patients with neuro-Behçet's disease. Computed tomography showed low-density lesions with or without mass effect and contrast enhancement. Magnetic resonance imaging revealed scattered areas of high signal intensity on T2-weighted images, and iso or low signal intensity on T1-weighted images with enhancement after gadolinium injection. These lesions affected all the central nervous system structures with predilection to the brain stem, basal brain ganglia, internal capsula, subcortical and deep cerebral white matter. By its availability, computed tomography remains a precious tool for diagnosis and assessment of severity of neurological involvement. Brain magnetic resonance imaging reveals silent lesions on CT, specifies their exact topography, identifies lesional association reminiscent of neuro-Behçet and contributes to the differential diagnosis with multiple sclerosis. CT and MRI permit the follow-up of lesions under treatment and evaluate prognosis.
