Magnetic Resonance Imaging in the Evaluation of Central Nervous System Manifestations in Systemic Lupus Erythematosus

Clinical Reviews in Allergy - Tập 34 - Trang 361-366 - 2007
Simone Appenzeller1,2, G. Bruce Pike2, Ann E. Clarke1,3
1Divisions of Clinical Immunology/Allergy and Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montreal, Canada
2McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
3Divisions of Clinical Immunology/Allergy, Montreal General Hospital, Montreal, Canada

Tóm tắt

Central nervous system (CNS) manifestations are often observed in systemic lupus erythematosus (SLE) patients during the course of their disease. The prevalence of CNS manifestations ranges between 17 and 75%, reflecting different methods of patient selection and assessment, varying levels of assessor expertise, and lack of a consensus for diagnosing active and chronic neuropsychiatric (NP) manifestations. Postulated pathogenic mechanisms of peripheral and CNS events include vasculopathy, autoantibody effects, and systemic inflammation. Diagnosis is often difficult because of the lack of standardized diagnostic techniques. Magnetic resonance imaging (MRI) is considered the gold standard for the evaluation of CNS manifestations in SLE patients in clinical practice. MRI findings are diverse, and atrophy and hyperintense white matter lesions often correlate poorly with clinical manifestations, occurring also in patients without marked CNS signs and symptoms. We will describe MRI findings in SLE patients and discuss the usefulness of different MRI techniques in evaluating acute and chronic CNS manifestations.

Tài liệu tham khảo

Huizinga TW, Steens SC, van Buchem MA (2001) Imaging modalities in central nervous system systemic lupus erythematosus. Curr Opin Rheumatol 13:383–388 Cotton F, Bouffard-Vercelli J, Hermier M et al (2004) MRI of central nervous system in a series of 58 systemic lupus erythematosus (SLE) patients with or without overt neuropsychiatric manifestations. Rev Med Interne 25:8–15 Shoenfeld Y (2007) To smell autoimmunity: anti-P-ribosomal autoantibodies, depression, and the olfactory system. J Autoimmun 28:165–169 Stojanovich L, Zandman-Goddard G, Pavlovich S, Sikanich N (2007) Psychiatric manifestations in systemic lupus erythematosus. Autoimmun Rev 6:421–426 Muscal E, Myones BL (2007) The role of autoantibodies in pediatric neuropsychiatric systemic lupus erythematosus. Autoimmun Rev 6:215–217 Hanly JG, Harrison MJ (2005) Management of neuropsychiatric lupus. Best Pract Res Clin Rheumatol 19:799–821 Hanly JG, Urowitz MB, Sanchez-Guerrero J, Bae SC, Gordon C, Wallace DJ et al (2007) Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: an international inception cohort study. Arthritis Rheum 56:265–273 Appenzeller S, Costallat LT, Cendes F (2007) Central nervous system manifestations in systemic lupus erythematosus. Curr Rheumatol Rev 3:205–214 Appenzeller S, Bonilha L, Rio PA, Min Li L, Costallat LT, Cendes F (2007) Longitudinal analysis of gray and white matter loss in patients with systemic lupus erythematosus. Neuroimage 34:694–701 Whitwell JL, Jack CR Jr, Parisi JE, Knopman DS, Boeve BF, Petersen RC et al (2007) Rates of cerebral atrophy differ in different degenerative pathologies. Brain 130:1148–1158 Stimmler MM, Coletti PM, Quismorio FP Jr (1993) Magnetic resonance imaging of the brain in neuropsychiatric systemic lupus erythematosus. Semin Arthritis Rheum 22:335–349 Cauli A, Montaldo C, Peltz MT, Nurchis P, Sanna G, Garau P et al (1994) Abnormalities of magnetic resonance imaging of the central nervous system in patients with systemic lupus erythematosus correlate with disease severity. Clin Rheumatol 13:615–618 Sibbitt WL Jr, Sibbitt RR, Griffey RH, Eckel C, Bankhurst AD (1989) Magnetic resonance and computed tomographic imaging in the evaluation of acute neuropsychiatric disease in systemic lupus erythematosus. Ann Rheum Dis 48:1014–1022 Appenzeller S, Rondina JM, Li LM, Costallat LT, Cendes F (2005) Cerebral and corpus callosum atrophy in systemic lupus erythematosus. Arthritis Rheum 52:2783–2789 Ainiala H, Dastidar P, Loukkola J, Lehtimaki T, Korpela M, Peltola J et al (2005) Cerebral MRI abnormalities and their association with neuropsychiatric manifestations in SLE: a population-based study. Scand J Rheumatol 34:376–382 Chinn RJ, Wilkinson ID, Hall-Craggs MA, Paley MN, Shortall E, Carter S et al (1997) Magnetic resonance imaging of the brain and cerebral proton spectroscopy in patients with systemic lupus erythematosus. Arthritis Rheum 40:36–46 Sanna G, Piga M, Terryberry JW, Peltz MT, Giagheddu S, Satta L et al (2000) Central nervous system involvement in systemic lupus erythematosus: cerebral imaging and serological profile in patients with and without overt neuropsychiatric manifestations. Lupus 9:573–583 Appenzeller S, Carnevalle AD, Li LM, Costallat LT, Cendes F (2006) Hippocampal atrophy in systemic lupus erythematosus. Ann Rheum Dis 65:1585–1589 Benedetti B, Rovaris M, Judica E, Donadoni G, Ciboddo G, Filippi M (2007) Assessing “occult” cervical cord damage in patients with neuropsychiatric systemic lupus erythematosus using diffusion tensor MRI (2007) J Neurol Neurosurg Psychiatry. J Neurol Neurosurg Psychiatry 78:893–895 Graham JW, Jan W (2003) MRI and the brain in systemic lupus erythematosus. Lupus 12:891–896 Sibbitt WL Jr, Schmidt PJ, Hart BL, Brooks WM (2003) Fluid attenuated inversion recovery (FLAIR) imaging in neuropsychiatric systemic lupus erythematosus. J Rheumatol 30:1983–1989 Vermeer SE, Priens ND, den Heijer T, Hofman A, Koudstaal PJ, Breteler MB (2003) Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med 348:1215–1222 Rovaris M, Viti B, Ciboddo G et al (2000) Brain involvement in systemic immune mediated diseases: magnetic resonance and magnetization transfer imaging study. J Neurol Neurosurg Psychiatry 68:170–177 Dousset V, Grossman RI, Ramer KN et al (1992) Experimental allergic encephalomyelitis and multiple sclerosis: lesion characterization with magnetization transfer imaging. Radiology 182:483–491 Pike GB, De Stefano N, Narayanan S et al (2000) Multiple sclerosis: magnetization transfer MR imaging of white matter before lesion appearance on T2-weighted images. Radiology 215:824–830 Kucharczyk W, Macdonal PM, Stanisz G et al (1994) Relaxivity and magnetization transfer of white matter lipids at MR imaging: importance of cerebrosides and pH. Radiology 192:521–529 Bosma GP, Rood MJ, Huizinga TW, de Jong BA, Bollen EL, van Buchem MA (2000) Detection of cerebral involvement in patients with active neuropsychiatric systemic lupus erythematosus by the use of volumetric magnetization transfer imaging. Arthritis Rheum 43:2428–2436 Steens SC, Admiraal-Behloul F, Bosma GP, Steup-Beekman GM, Olofsen H, Le Cessie S, Huizinga TW, Van Buchem MA (2004) Selective gray matter damage in neuropsychiatric lupus. Arthritis Rheum 50:2877–2881 Emmer BJ, Steens SC, Steup-Beekman GM, van der Grond J, Admiraal-Behloul F, Olofsen H, Bosma GP, Ouwendijk WJ, Huizinga TW, van Buchem MA (2006) Detection of change in CNS involvement in neuropsychiatric SLE: a magnetization transfer study. J Magn Reson Imaging 24:812–816 Schaefer PW, Grant PE, Gonzalez RG (2000) Diffusion-weighted MRimaging of the brain. Radiology 217:331–345 Zhang L, Harrison M, Heier LA, Zimmerman RD, Ravdin L, Lockshin M, Ulug AM (2007) Diffusion changes in patients with systemic lupus erythematosus. Magn Reson Imaging 25:399–405 Hughes M, Sundgren PC, Fan X, Foerster B, Nan B, Welsh RC, Williamson JA, Attwood J, Maly PV, Chenevert TL, McCune W, Gebarski S (2007) Diffusion tensor imaging in patients with acute onset of neuropsychiatric systemic lupus erythematosus: a prospective study of apparent diffusion coefficient, fractional anisotropy values, and eigenvalues in different regions of the brain. Acta Radiol 48:213–222 Bosma GP, Huizinga TW, Mooijaart SP, Van Buchem MA (2003) Abnormal brain diffusivity in patients with neuropsychiatric systemic lupus erythematosus. AJNR Am J Neuroradiol 24:850–854 Hughes M, Sundgren PC, Fan X, Foerster B, Nan B, Welsh RC, Williamson JA, Attwood J, Maly PV, Chenevert TL, McCune W, Gebarski S (2007) Diffusion tensor imaging in patients with acute onset of neuropsychiatric systemic lupus erythematosus: a prospective study of apparent diffusion coefficient, fractional anisotropy values, and eigenvalues in different regions of the brain. Acta Radiol 48:213–222 Moritani T, Shrier DA, Numaguchi Y et al (2001) Diffusion-weighted echoplanar MR imaging of CNS involvement in systemic lupus erythematosus. Acta Radiol 8:741–753 Bosma GP, van Buchem MA, Rood MJ et al (2000) Comparison of ADC histograms of patients with neuropsychiatric systemic lupus erythematosus and healthy volunteers. Proc Intl Soc Mag Res Med 8:1244 Goldberg-Zimring D, Warfield SK (2006) Novel image processing techniques to better understand white matter disruption in multiple sclerosis. Autoimmun Rev 5:544–548 Appenzeller S, Costallat LT, Li LM, Cendes F (2006) Magnetic resonance spectroscopy in the evaluation of central nervous system manifestations of systemic lupus erythematosus. Arthritis Rheum 55:807–811 Appenzeller S, Li ML, Costallat LTL, Cendes F (2005) Evidence of reversible axonal dysfunction in systemic lupus erythematosus: a proton MRS study. Brain 128:2933–29340 Castellino G, Govoni M, Padovan M, Colamussi P, Borrelli M, Trotta F (2005) Proton magnetic resonance spectroscopy may predict future brain lesions in SLE patients: a functional multi-imaging approach and follow up. Ann Rheum Dis 64:1022–1027 Rocca MA, Filippi M (2007) Functional MRI in multiple sclerosis. J Neuroimaging 17:36S–41S Hoge RD, Atkinson J, Gill B, Crelier GR, Marrett S, Pike GB (1999) Linear coupling between cerebral blood flow and oxygen consumption in activated human cortex. Proc Natl Acad Sci U S A 96:9403–9408 Appenzeller S, Amorim BJ, Ramos CD, Rio PA, de C Etchebehere EC, Camargo EE, Cendes F, Costallat LT (2007) Voxel-based morphometry of brain SPECT can detect the presence of active central nervous system involvement in systemic lupus erythematosus. Rheumatology (Oxford) 46:467–472