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Systemic Lupus Erythematosus: Brain MR Imaging and Single-Voxel Hydrogen 1 MR Spectroscopy¹

¹ From the Departments of Radiology (M.K.L., C.H.S., H.J.K., Y.K.C., S.H.C., J.H.K.) and Internal Medicine (W.P.), Inha University College of Medicine, 7-206 3rd St, Shinheung-Dong, Choong-Gu, Incheon 400-103, Korea; and the NMR Laboratory, Asan Institute for Life Sciences, Seoul, Korea (J.H.L.). Received August 27, 1999; revision requested October 8; final revision received March 7, 2000; accepted March 24. Address correspondence to M.K.L. (e-mail: kanlim@chollian.net).

PURPOSE: To evaluate the usefulness of magnetic resonance (MR) imaging and hydrogen 1 MR spectroscopy in the detection of brain involvement in patients with systemic lupus erythematosus (SLE) with or without neuropsychiatric symptoms.

MATERIALS AND METHODS: Twenty-six patients who had SLE with (n = 17) or without (n = 9) neuropsychiatric symptoms were examined at MR imaging and ¹H MR spectroscopy. The voxel was placed in the basal ganglia and peritrigonal white matter. Eight healthy volunteers were included.

RESULTS: Five of nine patients with major neuropsychiatric symptoms and one of eight patients with minor neuropsychiatric symptoms had abnormal MR imaging findings. ¹H MR spectroscopy showed a significantly decreased N-acetylaspartate–creatine (Cr) ratio in the basal ganglia and an increased choline-Cr ratio in the peritrigonal white matter in patients with major symptoms compared with those with minor symptoms, those without symptoms, and healthy control subjects. Among patients with major symptoms, there was no difference in metabolite ratios between those with and those without abnormal MR imaging findings. Among patients with normal MR imaging findings, abnormal spectral changes were observed only in those with major neuropsychiatric symptoms. In patients without neuropsychiatric symptoms, results of ¹H MR spectroscopy and MR imaging were normal.

CONCLUSION: In patients with SLE, ¹H MR spectroscopic findings seem to reflect the cerebral metabolic disturbance related to the severity of the neuropsychiatric symptoms and are not related to the presence of abnormal MR imaging findings.

Index terms: Brain, diseases, 10.61, 10.78, 10.83 • Brain, metabolism • Brain, MR, 10.121411, 10.121415, 10.12145 • Lupus erythematosus, 10.61 • Magnetic resonance (MR), spectroscopy, 10.12145

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