Perfusion-weighted MR Imaging in Cerebral Lupus Erythematosus
Academic Radiology, 07/16/2012

Wang PI et al. – SLE patients have increased cerebral blood volume (CBV) and cerebral blood flow (CBF) compared to healthy controls. The SLE patients with clinical markers for active disease have elevated CBV, CBF, and mean transit time (MTT) 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 Neuropsychiatric systemic lupus erythematosus (NPSLE).

• 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 (MTT) values were calculated.
• Subjects underwent clinical evaluation with SLEDAI and serum antibodies.

• 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 MTT 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).