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Perfusion-weighted MR Imaging in Cerebral Lupus Erythematosus

Wang, Page I. ; Cagnoli, Patricia C. ; McCune, William J. ; Schmidt-Wilcke, Tobias ; Lowe, Suzan E. ; Graft, Courtney C. ; Gebarski, Stephen S. ; Chenevert, Thomas L. ; Khalatbari, Shokoufeh and Myles, James D. , et al. (2012) In Academic Radiology 19(8). p.965-970
Abstract
Rationale and Objective: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a diagnostically challenging, severe, and life-threatening condition, which is currently lacking a "gold standard." Our aim with this study is to look for magnetic resonance (MR) perfusion differences in NPSLE, SLE, and healthy control (HC) patients and correlate our findings with clinical parameters. Materials and Methods: Twenty-four NPSLE patients, 21 SLE patients, and 21 HC underwent dynamic susceptibility contrast enhanced MR perfusion using a 3-T scanner. Nine prospectively selected intracranial regions of interest were placed in white and gray matter and the cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MU) values were... (More)
Rationale and Objective: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a diagnostically challenging, severe, and life-threatening condition, which is currently lacking a "gold standard." Our aim with this study is to look for magnetic resonance (MR) perfusion differences in NPSLE, SLE, and healthy control (HC) patients and correlate our findings with clinical parameters. Materials and Methods: Twenty-four NPSLE patients, 21 SLE patients, and 21 HC underwent dynamic susceptibility contrast enhanced MR perfusion using a 3-T scanner. Nine prospectively selected intracranial regions of interest were placed in white and gray matter and the cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MU) values were calculated. Subjects underwent clinical evaluation with SLEDAI and serum antibodies. Results: The SLE patients had higher CBF and CBV compared to the HC overall (P =.01) and in specific areas (P =.03-.048). SLE patients with signs of active disease (elevated SLEDAI and anti-double-stranded DNA) had significantly elevated CBV, CBF, and MU in the posterior cingulate gyrus (P =.01-.02). No significant difference was seen in the magnetic resonance perfusion measurements of NPSLE patients compared to SLE and HC, although the NPSLE patients also showed higher CBV variability compared to the SLE (P =.0004) and HC cohort (P <.0001). Conclusion: SLE patients have increased CBV and CBF compared to healthy controls. The SLE patients with clinical markers for active disease have elevated CBV, CBF, and MU in the posterior cingulate gyrus. NPSLE patients show increased variability in perfusion measurements, which may explain why susceptibility contrast enhanced MRI has not yet provided a specific target for NPSLE. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
SLE, lupus, neuropsychiatric lupus, perfusion, MRI
in
Academic Radiology
volume
19
issue
8
pages
965 - 970
publisher
Elsevier
external identifiers
  • wos:000306720000008
  • scopus:84863448726
  • pmid:22608862
ISSN
1878-4046
DOI
10.1016/j.acra.2012.03.023
language
English
LU publication?
yes
id
33677a23-d665-4eef-b446-466644e80b5b (old id 3079869)
date added to LUP
2016-04-01 14:12:07
date last changed
2022-04-22 01:56:04
@article{33677a23-d665-4eef-b446-466644e80b5b,
  abstract     = {{Rationale and Objective: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a diagnostically challenging, severe, and life-threatening condition, which is currently lacking a "gold standard." Our aim with this study is to look for magnetic resonance (MR) perfusion differences in NPSLE, SLE, and healthy control (HC) patients and correlate our findings with clinical parameters. Materials and Methods: Twenty-four NPSLE patients, 21 SLE patients, and 21 HC underwent dynamic susceptibility contrast enhanced MR perfusion using a 3-T scanner. Nine prospectively selected intracranial regions of interest were placed in white and gray matter and the cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MU) values were calculated. Subjects underwent clinical evaluation with SLEDAI and serum antibodies. Results: The SLE patients had higher CBF and CBV compared to the HC overall (P =.01) and in specific areas (P =.03-.048). SLE patients with signs of active disease (elevated SLEDAI and anti-double-stranded DNA) had significantly elevated CBV, CBF, and MU in the posterior cingulate gyrus (P =.01-.02). No significant difference was seen in the magnetic resonance perfusion measurements of NPSLE patients compared to SLE and HC, although the NPSLE patients also showed higher CBV variability compared to the SLE (P =.0004) and HC cohort (P &lt;.0001). Conclusion: SLE patients have increased CBV and CBF compared to healthy controls. The SLE patients with clinical markers for active disease have elevated CBV, CBF, and MU in the posterior cingulate gyrus. NPSLE patients show increased variability in perfusion measurements, which may explain why susceptibility contrast enhanced MRI has not yet provided a specific target for NPSLE.}},
  author       = {{Wang, Page I. and Cagnoli, Patricia C. and McCune, William J. and Schmidt-Wilcke, Tobias and Lowe, Suzan E. and Graft, Courtney C. and Gebarski, Stephen S. and Chenevert, Thomas L. and Khalatbari, Shokoufeh and Myles, James D. and Watcharotone, Kuanwong and Cronin, Paul and Sundgren, Pia}},
  issn         = {{1878-4046}},
  keywords     = {{SLE; lupus; neuropsychiatric lupus; perfusion; MRI}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{965--970}},
  publisher    = {{Elsevier}},
  series       = {{Academic Radiology}},
  title        = {{Perfusion-weighted MR Imaging in Cerebral Lupus Erythematosus}},
  url          = {{http://dx.doi.org/10.1016/j.acra.2012.03.023}},
  doi          = {{10.1016/j.acra.2012.03.023}},
  volume       = {{19}},
  year         = {{2012}},
}