TITLE:
The Value and the Variability of Magnetic Resonance Imaging in Patients with Systemic Lupus Erythematosus and Antiphospholipid Syndrome
AUTHORS:
Ekaterini Solomou, Aspasia Rigopoulou, Theodoros Petsas
KEYWORDS:
Systemic Lupus Erythematosus, Antiphospholipid Syndrome, MRI, Brain MRI
JOURNAL NAME:
Open Journal of Radiology,
Vol.5 No.1,
March
26,
2015
ABSTRACT: Objectives:
The objectives of this article are twofold: To review the value and the
variability of MR imaging (MRI) findings in patients with systemic lupus
erythematosus (SLE) and to reveal the frequency of central nervous system (CNS)
involvement. SLE is a complex multisystem autoimmune connective tissue disorder
with a broad spectrum of clinical presentations. Materials and methods: We
present three cases, two with neurological symptoms and one case with musculoskeletal
symptoms. Patients were imaged in the MRI department of the University Hospital
of Patras. All patients had a previous history of antiphospholipid syndrome and
known SLE. Results: None of the pts had a normal brain MRI. Abnormal lesions
were typically high on FLAIR and T2-weighted images. One patient showed
myositis of the tibial muscles bilateral and although she did not reveal any
neurological symptoms, because of the presence of APS, she underwent brain MRI
to detect any cerebrovascular involvement. The brain MRI was abnormal and
showed extensive lesions and porencephalia. In all cases the differential
diagnosis of the brain MRI included vasculitis, focal ischemia, multiple
sclerosis or other entities. Parenchymal volume loss-cerebral atrophy, incompatible
with their age, was obvious in all patients. Conclusion: Magnetic resonance
imaging is the gold standard for the investigation of central nervous system in
patients suffering from lupus. Lupus patients who also develop antiphospholipid
syndrome must be submitted to brain MRI because central nervous involvement is
very common and serious, although symptoms may be silent as in our case.