Magnetic resonance volumetry of pathological brain foci in patients with systemic lupus erythematosus.

OBJECTIVE The aim of our study was to determine the volume of pathological foci in the brain tissue of patients suffering from systemic lupus erythematosus (SLE) with or without neuropsychiatric manifestations (NP), and also to find out if that volume depends on the study subjects' data and clinical records. Magnetic resonance (MR) scans of patients with SLE and, in particular, signs of neuropsychiatric involvement, show pathological foci in the cerebral white matter. METHODS A total of 53 SLE patients, 29 with signs of neuropsychiatric syndromes (NPSLE), 24 without, and 16 healthy controls underwent prospective volumetric magnetic resonance imaging in a flow attenuated inversion recovery (FLAIR) sequence. The disease activity was expressed in terms of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). RESULTS All the patients in this study were found to have a larger volume of pathological foci in the brain tissue than the healthy controls. The NPSLE subgroup had a larger volume of pathological foci than the SLE patients without NP (p<0.001). The largest volume of such foci was found in the patients with a history of cerebrovascular disease (p<0.05). These were also noted for a correlation between the duration of the disease and the period of time elapsed from the onset of the first signs of neuropsychiatric lupus (p<0.01). Correlation with SLEDAI-rated disease activity was found statistically significant in all the patients (p<0.05) and in those with NPSLE at a level of p<0.01. CONCLUSION We found that the lesion load was significantly larger in NPSLE than in SLE patients free from NP and controls. Our measurement revealed a positive correlation between the lesion load and SLEDAI in the whole SLE patients group, particularly in the subgroup with NP manifestation. In the future, longitudinal volumetry might conceivably facilitate the therapeutical effect rating.