Systemic lupus erythematosus MRI: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 12: Line 12:
! style="background: #4479BA; color: #FFFFFF; " |Disease
! style="background: #4479BA; color: #FFFFFF; " |Disease
! style="background: #4479BA; color: #FFFFFF; " |MRI
! style="background: #4479BA; color: #FFFFFF; " |MRI
!
! style="background: #4479BA; color: #FFFFFF; " |Preview
|-
|-
| rowspan="4" style="background: #DCDCDC; " |Gastrointestinal system
| rowspan="4" style="background: #DCDCDC; " |Gastrointestinal system
Line 21: Line 21:
** T2: nonspecific, increased periportal [[edema]]
** T2: nonspecific, increased periportal [[edema]]
|
|
= File:9763697dab2e8388d7a54b513a3e42 jumbo.jpg =
[[File:9763697dab2e8388d7a54b513a3e42 jumbo.jpg|300px]]
 
[[File:9531e159d25c6beef968d6c1caf46c jumbo.jpg|300px]]
= File:9531e159d25c6beef968d6c1caf46c jumbo.jpg =
|-
|-
![[Cholecystitis]]
![[Cholecystitis]]
Line 30: Line 29:
* [[Gallbladder|Gall bladder]] wall thickening
* [[Gallbladder|Gall bladder]] wall thickening
|
|
= File:Acute-cholecystitis-3.jpg =
[[File:Acute-cholecystitis-3.jpg|300px]]
|-
|-
![[Acute pancreatitis|Pancreatitis]]
![[Acute pancreatitis|Pancreatitis]]
Line 41: Line 40:
**** Circumscribed fluid collection
**** Circumscribed fluid collection
|
|
= File:C13ada80fec4008d775777547a65ef big gallery.jpg =
[[File:C13ada80fec4008d775777547a65ef big gallery.jpg|300px]]
|-
|-
![[Mesenteric vascular occlusion|Mesenteric vasculitis]]
![[Mesenteric vascular occlusion|Mesenteric vasculitis]]
Line 61: Line 60:
* The normal [[pericardial]] thickness is considered 2 mm while a thickness of over 4 mm suggests a [[pericarditis]]
* The normal [[pericardial]] thickness is considered 2 mm while a thickness of over 4 mm suggests a [[pericarditis]]
|
|
= File:59f9b477529f76aad3615898fb5d6f big gallery.jpg =
[[File:59f9b477529f76aad3615898fb5d6f big gallery.jpg|300px]]
|-
|-
![[Pericardial effusion]]
![[Pericardial effusion]]
Line 74: Line 73:
** Early postcontrast enhancement due to regional vasodilatation and increased blood volume, secondary to the [[inflammation]]
** Early postcontrast enhancement due to regional vasodilatation and increased blood volume, secondary to the [[inflammation]]
|
|
= File:Lymphocytic-myocarditis.jpg =
[[File:Lymphocytic-myocarditis.jpg|300px]]
|-
|-
| rowspan="4" style="background: #DCDCDC; " |Neurological involvement
| rowspan="4" style="background: #DCDCDC; " |Neurological involvement
Line 84: Line 83:
* Detects clinically silent [[Lesion|lesions]]
* Detects clinically silent [[Lesion|lesions]]
|
|
= File:Ec9e2a6a4c1d377bdee5f0ccbbf180 big gallery.jpg =
[[File:Ec9e2a6a4c1d377bdee5f0ccbbf180 big gallery.jpg|300px]]
|-
|-
![[Stroke]]
![[Stroke]]
Line 93: Line 92:
* High T2 signal after 6 hours of [[stroke]]
* High T2 signal after 6 hours of [[stroke]]
|
|
= File:Subacute-middle-cerebral-artery-infarct.jpg =
[[File:Subacute-middle-cerebral-artery-infarct.jpg|300px]]
|-
|-
![[Neuropathies]]
![[Neuropathies]]
Line 104: Line 103:
*** Contrast enhancement of the [[nerve]], best seen with fat-suppressed T1 coronal images
*** Contrast enhancement of the [[nerve]], best seen with fat-suppressed T1 coronal images
|
|
= File:D1797f6a1a111e62b0f9ba00fc93bb big gallery.jpg =
[[File:D1797f6a1a111e62b0f9ba00fc93bb big gallery.jpg|300px]]
 
[[File:Myelitis.jpg|300px]]
= File:Myelitis.jpg =
|-
|-
![[Encephalitis|Autoimmune encephalitis]]
![[Encephalitis|Autoimmune encephalitis]]
Line 116: Line 114:
* Patchy areas of enhancement
* Patchy areas of enhancement
|
|
= File:11b6d7d362d132027d14f5a6a12236 big gallery.jpg =
[[File:11b6d7d362d132027d14f5a6a12236 big gallery.jpg|300px]]
|-
|-
| rowspan="4" style="background: #DCDCDC; " |Musculoskeletal involvement
| rowspan="4" style="background: #DCDCDC; " |Musculoskeletal involvement
Line 125: Line 123:
** Tapering of digital [[vessels]]
** Tapering of digital [[vessels]]
|
|
= File:Secondary-raynauds-phenomenon.jpg =
[[File:Secondary-raynauds-phenomenon.jpg|300px]]
|-
|-
![[Myositis]]
![[Myositis]]
Line 131: Line 129:
* [[Edema|Intramuscular edema]] (increased high T2 signal)
* [[Edema|Intramuscular edema]] (increased high T2 signal)
|
|
= File:11f542413e3f946e7401ba6184820f big gallery.jpg =
[[File:11f542413e3f946e7401ba6184820f big gallery.jpg|300px]]
|-
|-
![[Arthritis]]/[[tenosynovitis]]
![[Arthritis]]/[[tenosynovitis]]
Line 139: Line 137:
* [[Synovial]] overgrowth
* [[Synovial]] overgrowth
|
|
= File:A87cc2247174b9aad66f9bfe89bb1c big gallery.jpg =
[[File:A87cc2247174b9aad66f9bfe89bb1c big gallery.jpg|300px]]
|-
|-
![[Osteonecrosis]] ([[Avascular necrosis]])
![[Osteonecrosis]] ([[Avascular necrosis]])
Line 153: Line 151:
** In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to [[bone marrow]] edema
** In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to [[bone marrow]] edema
|
|
= File:Medullary-bone-infarct-lupus-on-corticosteroids.JPG =
[[File:Medullary-bone-infarct-lupus-on-corticosteroids.JPG|300px]]
 
[[File:Osteoprosis mri.jpg|300px]]
= File:Osteoprosis mri.jpg =
|}
|}


Revision as of 15:43, 1 August 2017

Systemic lupus erythematosus Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Systemic lupus erythematosus from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Lupus and Quality of Life

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Systemic lupus erythematosus MRI On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Systemic lupus erythematosus MRI

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

National Guidelines Clearinghouse

NICE Guidance

FDA on Systemic lupus erythematosus MRI

on Systemic lupus erythematosus MRI

Systemic lupus erythematosus MRI in the news

Blogs onSystemic lupus erythematosus MRI

Directions to Hospitals Treating Systemic lupus erythematosus

Risk calculators and risk factors for Systemic lupus erythematosus MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

On abdominal MRI, systemic lupus erythematosus (SLE) may be characterized by hepatomegaly, pancreatic parenchymal enlargement, and hypervascularity of mesentery. On cardiac MRI, SLE may be characterized by mitral leaflet thickening, pericardial thickness, and pericardial effusions. On brain MRI, SLE may be characterized by white matter lesions, changes in blood circulation of the brain, and patchy areas of enhancement. On musculoskeletal MRI, SLE may be characterized by intramuscular edema, proliferative tenosynovitis, and bone marrow edema.

Key MRI findings in systemic lupus erythematosus

Most of the SLE complications can be visualized with other more feasible imaging techniques. So, MRI is not the imaging modality of choice for the diagnosis of most complications of SLE, but if done, the following changes can be found in different organ systems of the body:[1][2][3][4][5][6][7][8][9][10][11]

Organ involvement Disease MRI Preview
Gastrointestinal system Hepatitis

Cholecystitis

Pancreatitis
  • Contrast-enhanced MR is equivalent to CT in the assessment of pancreatitis
    • Abnormalities that may be seen in the pancreas include:
      • Parenchymal enlargement
      • Surrounding retroperitoneal fat stranding
      • Abscess formation
        • Circumscribed fluid collection

Mesenteric vasculitis
  • Comb sign
Cardiac involvement Mitral stenosis
Acute pericarditis

Pericardial effusion
  • Fluid density material surrounding the heart
Myocarditis
  • Regional or global wall motion abnormalities
  • Pericardial effusion
    • Early postcontrast enhancement due to regional vasodilatation and increased blood volume, secondary to the inflammation

Neurological involvement General

Stroke
  • Changes in brain vessel blood flow (occlusion on MRA)  
  • No parenchymal changes 
  • Slow or stagnant flow in vessels as a loss of normal flow void 
  • High T2 signal after 6 hours of stroke

Neuropathies

Autoimmune encephalitis
  • Mostly in temporal lobes and limbic systems
  • Bilateral involvement is most common (60%), although often asymmetric
  • Cortical thickening
  • Increased T2/FLAIR signal intensity of affected regions
  • Patchy areas of enhancement

Musculoskeletal involvement Raynaud phenomen

Myositis

Arthritis/tenosynovitis

Osteonecrosis (Avascular necrosis)
  • Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging 
  • Bone marrow edema on MRI 
  • 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

References

  1. ↑ Appenzeller S (2013). "Magnetic resonance imaging in systemic lupus erythematosus: where do we stand?". Cogn Behav Neurol. 26 (2): 53–4. doi:10.1097/WNN.0b013e31829d5b60. PMID 23812167.
  2. ↑ Thurman JM, Serkova NJ (2015). "Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus". F1000Res. 4: 153. doi:10.12688/f1000research.6587.2. PMC 4536614. PMID 26309728.
  3. ↑ Lin K, Lloyd-Jones DM, Li D, Liu Y, Yang J, Markl M, Carr JC (2015). "Imaging of cardiovascular complications in patients with systemic lupus erythematosus". Lupus. 24 (11): 1126–34. doi:10.1177/0961203315588577. PMC 4567427. PMID 26038342.
  4. ↑ Sarbu N, Bargalló N, Cervera R (2015). "Advanced and Conventional Magnetic Resonance Imaging in Neuropsychiatric Lupus". F1000Res. 4: 162. doi:10.12688/f1000research.6522.2. PMC 4505788. PMID 26236469.
  5. ↑ Qin H, Guo Q, Shen N, Huang X, Wu H, Zhang M, Bao C, Chen S (2014). "Chest imaging manifestations in lupus nephritis". Clin. Rheumatol. 33 (6): 817–23. doi:10.1007/s10067-014-2586-2. PMID 24696368.
  6. ↑ Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part II: gastrointestinal, renal, and musculoskeletal manifestations". Clin Radiol. 68 (2): 192–202. doi:10.1016/j.crad.2012.06.109. PMID 22901453.
  7. ↑ Gal Y, Twig G, Mozes O, Greenberg G, Hoffmann C, Shoenfeld Y (2013). "Central nervous system involvement in systemic lupus erythematosus: an imaging challenge". Isr. Med. Assoc. J. 15 (7): 382–6. PMID 23943987.
  8. ↑ Shirato M, Hisa N, Fujikura Y, Ohkuma K, Kutsuki S, Hiramatsu K (1992). "[Imaging diagnosis of lupus enteritis--especially about sonographic findings]". Nihon Igaku Hoshasen Gakkai Zasshi (in Japanese). 52 (10): 1394–9. PMID 1448334.
  9. ↑ Adachi JD, Lau A (2014). "Systemic lupus erythematosus, osteoporosis, and fractures". J. Rheumatol. 41 (10): 1913–5. doi:10.3899/jrheum.140919. PMID 25275093.
  10. ↑ Curiel R, Akin EA, Beaulieu G, DePalma L, Hashefi M (2011). "PET/CT imaging in systemic lupus erythematosus". Ann. N. Y. Acad. Sci. 1228: 71–80. doi:10.1111/j.1749-6632.2011.06076.x. PMID 21718325.
  11. ↑ Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part I: CNS, cardiovascular, and thoracic manifestations". Clin Radiol. 68 (2): 181–91. doi:10.1016/j.crad.2012.06.110. PMID 22901452.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Systemic_lupus_erythematosus_MRI&oldid=1333246"