1H-Magnetic Resonance Spectroscopy for The Early Diagnosis of Neuropsychiatric Systemic Lupus Erythematosus.
- Author:
Sung Kwon BAE
1
;
Jung Soo SONG
;
Won PARK
Author Information
1. Department of Internal Medicine, Inha University College of Medicine, Inchon, Korea.
- Publication Type:Original Article
- Keywords:
1H-MRS;
Neurometabolite;
NPSLE
- MeSH:
Antibodies, Anticardiolipin;
Autoantibodies;
Basal Ganglia;
Choline;
Creatine;
Early Diagnosis*;
Electroencephalography;
Healthy Volunteers;
Humans;
Lupus Vasculitis, Central Nervous System*;
Magnetic Resonance Imaging;
Spectrum Analysis*
- From:The Journal of the Korean Rheumatism Association
2000;7(4):370-380
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To investigate the usefulness of 1H-magnetic resonance spectroscopy (1H-MRS) for the early diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE). METHODS: Magnetic resonance image (MRI) and 1H-MRS were performed on fifteen normal volunteers (mean age, 29+/-6 years; age range, 24~40 years) and twenty seven patients with SLE: twelve (26+/-8 years; 16~42 years) with and fifteen (32+/-12 years; 13~57 years) without NPSLE. The localized 1H-MRS was performed by a GE 1.5T SIGNA MRI/MRS system (version 5.5) with active shielded gradients. For all spectra, a Stimulated Echo Acquisition Method (STEAM) localization sequence with three-pulse CHESS H2O suppression was used. The metabolite ratios of N-acetylaspartate (NAA) to creatine (Cr) and choline (Cho) to Cr measured on 1H-MRS of the basal ganglia (BG) and peritrigonal periventricular white matter (PWM). RESULTS: The level of disease activity makers (anti-dsDNA, C3, C4, SLEDAI score), autoantibodies (lupus anticoagulant, anticardiolipin antibody, antiribosomal-P), and EEG did not showed significant difference between the patients without NPSLE and with NPSLE (p>0.05). Thirteen percent (2/15) of patients without NPSLE and fifty percent (6/12) of patient with the NPSLE showed abnormality in MRI. 1H-MRS showed significantly decreased NAA/Cr ratio in BG and increased Cho/Cr ratio in PWM for the patients with NPSLE compared to the patients without NPSLE and normal volunteers (p<0.05). No correlation was shown between the maker of disease activity and NAA/Cr in BG or Cho/Cr ratio in PWM in the SLE group (p>0.05). But negative correlation was shown between NAA/Cr in BG and Cho/Cr ratio in PWM (r=-0.58, p<0.05). CONCLUSION: NAA/Cr ratio in BG was decreased and Cho/Cr in PWM was increased in NPSLE. The neurometabolite ratio measured by 1H-MRS may be useful in the early detection of NPSLE.
