Systemic lupus erythematosus MRI: Difference between revisions
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MRI is the most useful neuroimaging study in patients with SLE, particularly in those with focal neurologic defects, seizures, chronic cognitive dysfunction, or the antiphospholipid syndrome and neurologic dysfunction; it is less useful in patients with affective disorders, confusional states, or headache. Although MRI frequently detects clinically silent lesions, we have found the correlation with neuropsychiatric symptoms to be quite good. | MRI is the most useful neuroimaging study in patients with SLE, particularly in those with focal neurologic defects, seizures, chronic cognitive dysfunction, or the antiphospholipid syndrome and neurologic dysfunction; it is less useful in patients with affective disorders, confusional states, or headache. Although MRI frequently detects clinically silent lesions, we have found the correlation with neuropsychiatric symptoms to be quite good. | ||
* Cine cardiac MR imaging is a useful noninvasive tool for evaluating abnormal flow patterns, ventricular dimensions, stroke volume, and regional myocardial function, but echocardiography is essential for evaluating valvular disease | * Cine cardiac MR imaging is a useful noninvasive tool for evaluating abnormal flow patterns, ventricular dimensions, stroke volume, and regional myocardial function, but echocardiography is essential for evaluating valvular disease | ||
* Avascular necrosis | * Avascular necrosis (AVN) | ||
** Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging | |||
** Bone marrow edema on MRI with | |||
** Low-signal-intensity marginal areas on standard spin-echo T1- and T2-weighted images | |||
** Intermediate to high signal intensity inside bone tissue on T2-weighted images, producing a line of low signal intensity with an adjacent high-signal-intensity line | |||
** High signal intensity on T2-weighted images due to subchondral fractures that may be accompanied by fluid signal intensity or edema | |||
** Low signal intensity on T2-weighted images due to collapse of the articular surface | |||
* Early or subtle insufficiency fractures especially on T2-weighted MR imaging | |||
** In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to bone marrow edema. | |||
==Examples of MRI Findings in Systemic Lupus Erythematosus== | ==Examples of MRI Findings in Systemic Lupus Erythematosus== | ||
Revision as of 16:17, 5 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
magnetic resonance imaging (MRI), more often reveal erosive changes and abnormalities of the soft tissues, including capsular swelling, proliferative tenosynovitis, and synovial overgrowth
neurological
MRI is more sensitive than CT, and may reveal abnormalities that reflect focal neuropsychiatric lupus. However, MRI may also reveal white matter lesions or periventricular hyperintensities in patients with SLE who do not have neuropsychiatric symptoms. These white matter abnormalities may be difficult to interpret since they are present in 20 percent of the population younger than age 50, and in 90 percent of people older than age 70 .
MRI is the most useful neuroimaging study in patients with SLE, particularly in those with focal neurologic defects, seizures, chronic cognitive dysfunction, or the antiphospholipid syndrome and neurologic dysfunction; it is less useful in patients with affective disorders, confusional states, or headache. Although MRI frequently detects clinically silent lesions, we have found the correlation with neuropsychiatric symptoms to be quite good.
- Cine cardiac MR imaging is a useful noninvasive tool for evaluating abnormal flow patterns, ventricular dimensions, stroke volume, and regional myocardial function, but echocardiography is essential for evaluating valvular disease
- Avascular necrosis (AVN)
- Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging
- Bone marrow edema on MRI with
- Low-signal-intensity marginal areas on standard spin-echo T1- and T2-weighted images
- Intermediate to high signal intensity inside bone tissue on T2-weighted images, producing a line of low signal intensity with an adjacent high-signal-intensity line
- High signal intensity on T2-weighted images due to subchondral fractures that may be accompanied by fluid signal intensity or edema
- Low signal intensity on T2-weighted images due to collapse of the articular surface
- Early or subtle insufficiency fractures especially on T2-weighted MR imaging
- In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to bone marrow edema.