系统性红斑狼疮患者脑小血管病变的MRI初步研究

doi:DOI:10.12117/jccmi.2020.04.002

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摘要目的：应用MRI常规序列对系统性红斑狼疮（SLE）患者脑内血管周围间隙扩大（EPVS）、白质高信号（WMH）及腔隙灶进行评估，初步分析SLE患者脑小血管病变的MRI表现。材料与方法：回顾性收集29例SLE患者及29例年龄、性别与SLE组相匹配的健康体检者作为对照组。通过观察EPVS、WMH及腔隙灶的情况，对其进行相应的分级及评分。并记录SLE患者临床及化验室检查指标。应用SPSS 24.0版统计软件进行数据分析，等级资料用Kolmogorov-Smirnov Z检验分析组间差异，应用Spearman相关分析法分析EPVS、WMH及腔隙灶与临床、实验室检查之间的相关性。结果：在半卵圆中心，SLE组的EPVS评分（2.52±0.91）显著高于对照组（1.34±0.55，P<0.01）；SLE组脑室周围白质高信号（PVH）和深部脑白质高信号（DWMH）均较对照组更明显（P<0.01）；SLE组腔隙灶的发生率高于对照组（P＜0.05）。并且半卵圆中心EPVS及PVH与补体C3相关（r=0.505，0.400，P均＜0.05）；EPVS和WMH与病程呈正相关（r=0.460、0.428、0.416、0.404，P均＜0.05）。结论：脑小血管病变是SLE中枢神经系统病变的常见表现，并与补体C3及病程具有关联性。

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	车艺玮
	苗延巍
	蒋玉涵
	常佩佩
	宋清伟

关键词 ：红斑狼疮, 系统性, 脑血管障碍, 磁共振成像

Abstract：Objective: To evaluate MRI findings of enlarged perivascular space(EPVS), white matter hyperintense (WMH) and lacunes of cerebral small vessel disease(CSVD) in patients with systemic lupus erythematosus(SLE). Materials and Methods: Twenty-nine SLE patients and twenty-nine age- and sex-matched healthy subjects participated in this retrospective study. EPVS, WMH, and lacunes were rated by two radiologists. SPSS 24.0 was used for data statistical analysis, Kolmogorov-Smirnov Z test was used to analyze group difference, and Spearman correlation analysis was used to analyze the correlation between CSVD and clinical and laboratory examination. Results: In the centrum semiovale(CS), the EPVS score in the SLE group was higher than that in the control group(2.52±0.91, 1.34±0.55, P<0.01). The periventricular hyperintense(PVH) and deep white matter hyperintense(DWMH) in the SLE group were more significant than those in the control group(P<0.01), and the incidence of lacunes in SLE group was higher than that in the control group(P<0.05). In SLE group, EPVS in the CS and PVH were correlated with complement C3(r=0.505, 0.400, P<0.05), EPVS score and WMH were positively correlated with disease duration(r=0.460, 0.428, 0.416, 0.404, P<0.05). Conclusion: Cerebral small vessel disease is a common manifestation of central nervous system lesions in SLE patients and is associated with complement C3 and disease duration.

Key words： Lupus erythematosus, systemic Cerebrovascular disorders Magnetic resonance imaging

收稿日期: 2019-07-18

PACS:	R593.24
	Ｒ743
	Ｒ445.2

基金资助:国家自然科学基金项目（编号：81671646，81801657）。

通讯作者: 苗延巍，大连医科大学附属第一医院放射科，116011。E-mail：ywmiao716@163.com

作者简介: 车艺玮（1993-），女，辽宁鞍山人，在读硕士研究生。E-mail：cheyiwei2018@163.com

引用本文:

车艺玮，苗延巍，蒋玉涵，常佩佩，宋清伟. 系统性红斑狼疮患者脑小血管病变的MRI初步研究[J]. 中国临床医学影像杂志, 2020, 31(4): 234-237.
CHE Yi-wei, MIAO Yan-wei, JIANG Yu-han, CHANG Pei-pei, SONG Qing-wei. MRI findings of cerebral small vessel disease in patients with systemic lupus erythematosus. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(4): 234-237.

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http://www.jccmi.com.cn/CN/DOI:10.12117/jccmi.2020.04.002 或 http://www.jccmi.com.cn/CN/Y2020/V31/I4/234

[1]Tsokos GC. Systemic lupus erythematosus[J]. N Engl J Med, 2011, 365(22): 2110-2121. [2]Wiseman SJ, Ralston SH, Wardlaw JM. Cerebrovascular disease in rheumatic diseases: a systematic review and meta-analysis[J]. Stroke, 2016, 47(4): 943-950. [3]Wardlaw JM, Smith C, Dichgans M. Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging[J]. Lancet Neurol, 2013, 12(5): 483-497. [4]Doubal FN, MacLullich AMJ, Ferguson KJ, et al. Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease[J]. Stroke, 2010, 41(3): 450-454. [5]Potter GM, Chappell FM, Morris Z, et al. Cerebral perivascular spaces visible on magnetic resonance imaging: development of a qualitative rating scale and its observer reliability[J]. Cerebrovasc Dis, 2015, 39(3-4): 224-231. [6]Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5T in Alzheimer’s dementia and normal aging[J]. AJR, 1987, 149(2): 351-356. [7]Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration[J]. Lancet Neurol, 2013, 12(8): 822-838. [8]Potter GM, Doubal FN, Jackson CA, et al. Enlarged perivascular spaces and cerebral small vessel disease[J]. Int J Stroke, 2015, 10(3): 376-381. [9]Wardlaw JM. Blood-brain barrier and cerebral small vessel disease[J]. J Neurol Sci, 2010, 299(1-2): 66-71. [10]Achiron A, Faibel M. Sandlike appearance of Virchow-Robin spaces in early multiple sclerosis: a novel neuroradiologic marker[J]. AJNR, 2002, 23(3): 376-380. [11]Vos CMP, Geurts JJG, Montagne L, et al. Blood-brain barrier alterations in both focal and diffuse abnormalities on postmortem MRI in multiple sclerosis[J]. Neurobiol Dis, 2005, 20(3): 953-960. [12]Gareau PJ, Wymore AC, Cofer GP, et al. Imaging inflammation: direct visualization of perivascular cuffing in EAE by magnetic resonance microscopy[J]. J Magn Reson Imaging, 2002, 16(1): 28-36. [13]Ramage AE, Fox PT, Brey RL, et al. Neuroimaging evidence of white matter inflammation in newly diagnosed systemic lupus erythematosus[J]. Arthritis Rheum, 2011, 63(10): 3048-3057. [14]Kowal C, DeGiorgio LA, Lee JY, et al. Human lupus autoantibodies against NMDA receptors mediate cognitive impairment[J]. Proc Natl Acad Sci USA, 2006, 103(52): 19854-19859. [15]Miyata M, Kakeda S, Iwata S, et al. Enlarged perivascular spaces are associated with the disease activity in systemic lupus erythematosus[J]. Sci Rep, 2017, 7(1): 12566. [16]Sachdev PS, Wen W, Christensen H, et al. White matter hyperintensities are related to physical disability and poor motor function[J]. J Neurol Neurosurg Psychiatry, 2005, 76(3): 362-367. [17]Launer LJ, Berger K, Breteler MMB, et al. Regional variability in the prevalence of cerebral white matter lesions: an MRI study in 9 European countries(CASCADE)[J]. Neuroepidemiology, 2006, 26(1): 23-29. [18]Appenzeller S, Vasconcelos Faria A, Li LM, et al. Quantitative magnetic resonance imaging analyses and clinical significance of hyperintense white matter lesions in systemic lupus erythematosus patients[J]. Ann Neurol, 2008, 64(6): 635-643. [19]Baum KA, Hopf U, Nehrig C, et al. Systemic lupus erythematosus: neuropsychiatric signs and symptoms related to cerebral MRI findings[J]. Clin Neurol Neurosurg, 1993, 95(1): 29-34. [20]Friedman SD, Stidley CA, Brooks WM, et al. Brain injury and neurometabolic abnormalities in systemic lupus erythematosus[J]. Radiology, 1998, 209(1): 79-84. [21]Sibbitt WL, Brooks WM, Kornfeld M, et al. Magnetic resonance imaging and brain histopathology in neuropsychiatric systemic lupus erythematosus[J]. Semin Arthritis Rheum, 2010, 40(1): 32-52. [22]Kim KW, MacFall JR, Payne ME. Classification of white matter lesions on magnetic resonance imaging in elderly persons[J]. Biol Psychiatry, 2008, 64(4): 273-280. [23]DeCarli C, Fletcher E, Ramey V, et al. Anatomical mapping of white matter hyperintensities(WMH): exploring the relationships between periventricular WMH, deep WMH, and total WMH burden[J]. Stroke, 2005, 36(1): 50-55. [24]Shaharir SS, Osman SS, Md Rani SA, et al. Factors associated with increased white matter hyperintense lesion(WMHI) load in patients with systemic lupus erythematosus(SLE)[J]. Lupus, 2018, 27(1): 25-32. [25]Munoz DG, Hastak SM, Harper B, et al. Pathologic correlates of increased signals of the centrum ovale on magnetic resonance imaging[J]. Arch Neurol, 1993, 50(5): 492-497.