Magnetic resonance imaging of the brain and cerebral proton spectroscopy in patients with systemic lupus erythematosus
R.J.S. ChinnIain D. WilkinsonMargaret Hall‐CraggsM. PaleyE. ShortallS. CarterB. E. KendallDavid IsenbergStanton NewmanM. J. G. Harrisonfrcp
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Abstract:
To investigate the prevalence and extent of cerebral changes in patients with systemic lupus erythematosus (SLE) by magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS).SLE patients (47 women) and controls (25 women) underwent 1.5T MRI. A semiautomated segmentation technique calculated cerebrospinal fluid (CSF) and brain volumes. Proton MRS of the frontal and parieto-occipital white matter yielded metabolite ratios of N-acetyl groups (NA), choline, and creatine.Compared with the control group, the SLE patients more often had cerebral atrophy on MRI (32% versus 0%), confirmed by an increase in the CSF to intracranial volume ratio. The patients also had old infarcts and hemorrhages (8.5% versus 0%) and more small white matter lesions (23% versus 8% had > 5 such lesions). MRS showed relative reduction of NA peaks. Although no patient was studied when acutely ill, prior neurologic involvement was related to abnormal findings.MRI and MRS are helpful in the investigation of cerebral complications of SLE. There are chronic changes which may be ischemic in nature. Their precise cause, consequences, and prevention are current challenges.Keywords:
Proton magnetic resonance
Key words MRI spectroscopy - Metabolic disorders - Neurodegenerative disorders - Neuroinfections disorders
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Abbreviations: MR, magnetic resonance; MRI, magnetic resonance imaging; MRS, magnetic resonance spectroscopy; 1 H MRS, proton magnetic resonance spectroscopy; 31 P MRS, phosphorus magnetic resonance spectroscopy; CE-MRI, contrast-enhanced magnetic resonance imaging; VOI, volume of interest; CSI, chemical shift imaging; MRSI, magnetic resonance spectroscopic imaging; STEAM, stimulated echo acquisition mode; PRESS, point resolved spectroscopy; CHESS, chemical shift selective; W–F, water-to-fat ratio; PME, phosphomonoester; PDE, phosphodiester; PCr, phosphocreatine; SV, single-voxel.
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1H nuclear magnetic resonance (1H NMR) spectroscopy has found widespread applications in tumour studies. Several complementary NMR techniques have provided valuable information concerning tumours, including in vivo localized 1H NMR spectroscopy, ex vivo high-resolution 1H NMR spectroscopy of extracts of intact tissue biopsy samples, high-resolution magic angle spinning 1H NMR spectroscopy of intact tissue biopsy samples, and in vitro high-resolution 1H NMR spectroscopy of body fluids. On the basis of the combination of NMR measurements with multivariate data analysis, 1H NMR-based metabonomics has become a promisingly novel approach in the studies of tumour early diagnosis, processes and prognosis estimate.
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