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MRI spectroscopy lupus

Osman Perez, Kairavee Dave, Aimee Almanzar, Tajul Prodhan, Livasky Concepion
Neuropsychiatric systemic lupus erythematosus (NPSLE) has a wide variety of neurologic and psychiatric features. NPSLE symptoms and the psychotic features of primary psychiatric disorders often overlap with each other. These psychotic features often mask and delay the diagnosis of NPSLE. We present the case of a 59-year-old female previously diagnosed with bipolar disorder and generalized anxiety disorder presenting with altered mental status (AMS), subsequently diagnosed with neuropsychiatric lupus. Initially, medication overdose was suspected as an empty bottle of trazodone was found beside her...
October 23, 2017: Curēus
Ho Kyun Kim, Mun Han, Hui Joong Lee
A 36-year-old woman, diagnosed with systemic lupus erythematosus (SLE), showed bulbar symptoms including impaired memory, slurred speech and swallowing difficulty 7 days before admission. Magnetic resonance imaging (MRI) showed symmetric confluent hyperintensities in the bilateral cerebral white matter on T2 weighted imaging (T2-WI), extended into the genu of the internal capsule and the crus cerebri of the midbrain. MR spectroscopy showed increased choline and decreased N-acetyl aspartate (NAA) peak and positron emission computed tomography (PET CT) showed decreased fluorodeoxyglucose (FDG) uptake on the lateral portion of the frontal lobe, suggesting demyelination of the white matter...
July 2016: Iranian Journal of Radiology: a Quarterly Journal Published By the Iranian Radiological Society
Zhiyan Zhang, Yukai Wang, Zhiwei Shen, Zhongxian Yang, Li Li, Dongxiao Chen, Gen Yan, Xiaofang Cheng, Yuanyu Shen, Xiangyong Tang, Wei Hu, Renhua Wu
The diagnosis and pathology of neuropsychiatric systemic lupus erythematosus (NPSLE) remains challenging. Herein, we used multimodal imaging to assess anatomical and functional changes in brains of SLE patients instead of a single MRI approach generally used in previous studies. Twenty-two NPSLE patients, 21 non-NPSLE patients and 20 healthy controls (HCs) underwent 3.0 T MRI with multivoxel magnetic resonance spectroscopy, T1-weighted volumetric images for voxel based morphometry (VBM) and diffusional kurtosis imaging (DKI) scans...
January 13, 2016: Scientific Reports
A Guillen-Del Castillo, J Alonso, F Martínez-Valle, S Alonso-Vila, A C Garrido-Castro, M Vilardell-Tarrés, Á Rovira, J Ordi-Ros
Neuropsychiatric manifestations can be a serious complication of systemic lupus erythematosus, affecting nearly 56% of these patients. Frequently, acceptable clinical outcome is observed in neurolupus with immunosuppressive therapy. Different metabolites identified with MR spectroscopy may be associated with modifications in the natural history of this disease, specifically in the central nervous system. We report a case of neurolupus with progressive neurologic impairment despite aggressive immunosuppressive treatment...
September 2014: Lupus
Yaniv Gal, Gilad Twig, Oshry Mozes, Gahl Greenberg, Chen Hoffmann, Yehuda Shoenfeld
Systemic lupus erythematosus (SLE) is a complex autoimmune disorder involving multiple organs. One of the main sites of SLE morbidity is the central nervous system (CNS), specifically the brain. In this article we review several imaging modalities used for CNS examination in SLE patients. These modalities are categorized as morphological and functional. Special attention is given to magnetic resonance imaging (MRI) and its specific sequences such as diffusion-weighted imaging (DWI), diffuse tensor imaging (DTI) and magnetic resonance spectroscopy (MRS)...
July 2013: Israel Medical Association Journal: IMAJ
S Appenzeller, L M Li, L T L Costallat, F Cendes
To determine if neurometabolic changes in the white matter (WM) of systemic lupus erythematosus (SLE) patients may predict the appearance of small hyperintense lesions on T2-weighted magnetic resonance imaging (MRI) inside the magnetic resonance spectroscopy (MRS) region of interest (ROI). We included 30 SLE patients and 23 controls. We performed single voxel proton MRS over the superior-posterior region of the corpus callosum. We measured signals from N-acetyl-compounds (NAA), choline (Cho) and creatine-phosphocreatin (Cr) and determined NAA/Cr and Cho/Cr ratios...
2007: Lupus
Simone Appenzeller, Li Min Li, Lilian T L Costallat, Fernando Cendes
Our objective was to investigate axonal dysfunction in patients with systemic lupus erythematosus (SLE) using proton magnetic resonance spectroscopy (1H-MRS). We studied prospectively 90 SLE patients (mean age of 32.5 years) and 23 normal volunteers (mean age of 33.8 years). We performed single voxel proton MRS using point resolved spectroscopy sequence over the superior-posterior region of the corpus callosum. We measured signals from N-acetyl compounds [N-acetylaspartate (NAA)] at 2.01 p.p.m., choline-based compounds (Cho) at 3...
December 2005: Brain: a Journal of Neurology
Elizabeth Kozora, David B Arciniegas, Christopher M Filley, Misoo C Ellison, Sterling G West, Mark S Brown, Jack H Simon
OBJECTIVE: To correlate cognitive dysfunction with structural and neurometabolic brain findings in patients with non-neuropsychiatric systemic lupus erythematosus (non-NPSLE). BACKGROUND: Over 25% of non-NPSLE patients have cognitive dysfunction, but the cerebral basis of this observation is not well understood. METHOD: Seven patients with non-NPSLE and seven control subjects were given a series of neuropsychological tests and neuroimaging with magnetic resonance imaging and magnetic resonance spectroscopy...
September 2005: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
Pamela L Peterson, John S Axford, David Isenberg
The diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) is complex not only on account of the heterogeneous nature of neurological presentation but also because of the difficulty of differentiating lupus-related pathology from other neuropsychiatric diseases. Magnetic resonance imaging (MRI) remains the gold standard for the non-invasive assessment of NPSLE but there are problems, both with sensitivity and specificity. Both T(2) quantitation and the use of gadolinium have shown promise in differentiating acute from chronic lesions...
October 2005: Best Practice & Research. Clinical Rheumatology
P C Sundgren, J Jennings, J T Attwood, B Nan, S Gebarski, W J McCune, Y Pang, P Maly
MRI and 2D-CSI spectroscopy were performed in eight patients with systemic lupus erythematosus who presented with acute onset of neuropsychiatric lupus (NP-SLE), and in seven normal controls to evaluate for differences in metabolic peaks and metabolic ratios between the two groups. Also, the interval change of the metabolic peaks and their ratios during treatment in the NP-SLE patient group was evaluated. Metabolic peaks for N-acetyl-aspartate (NAA), choline (Cho), creatine (Cr), and lactate/lipids (LL) and their ratios (NAA/Cr, NAA/Cho, Cho/Cr, LL/Cr) were determined at initial presentation and 3 and 6 months later...
August 2005: Neuroradiology
G Castellino, M Govoni, M Padovan, P Colamussi, M Borrelli, F Trotta
OBJECTIVE: To determine whether single photon emission tomography (SPECT) and magnetic resonance spectroscopy (1H-MRS) can predict the appearance of new lesions in systemic lupus erythematosus (SLE), detectable by magnetic resonance imaging (MRI). METHODS: (99)Tc(m)-HMPAO-SPECT, brain MRI, and (1)H-MRS were done in eight women with SLE (mean age 31.8 years; disease duration 5.5 years). NAA/Cho, NAA/Cre, and Cho/Cre ratios were assessed in hypoperfused and normoperfused areas detected by SPECT that were normal on MRI examination...
July 2005: Annals of the Rheumatic Diseases
Katrin Morgen, Henry F McFarland, Stanley R Pillemer
OBJECTIVES: To examine the frequency of central nervous system (CNS) disease in primary Sjogrens syndrome (pSS) and indicate ways in which cerebral magnetic resonance imaging (MRI) may help determine the significance of CNS involvement. METHODS: The current review was based on a Medline (Pubmed) literature search through May 2003, focused on Sjogrens syndrome, other vasculitides, multiple sclerosis (MS), specific MRI techniques, and MRI findings with regard to the above-mentioned diseases...
December 2004: Seminars in Arthritis and Rheumatism
J W Graham, W Jan
Systemic lupus erythematosus (SLE) can affect any part of the central nervous system (CNS) from the cerebrum to the cauda eqina, giving rise to diverse neurological mainfestations. Despite clinically apparent symptoms and signs, imaging will commonly be normal while at times the magnitude of changes demonstrated on MRI may be out of proportion to the clinical presentation. We describe the MRI techniques used in CNS imaging and the pattern of presentation in SLE.
2003: Lupus
R Handa, P Sahota, M Kumar, N R Jagannathan, C S Bal, M Gulati, B M Tripathi, J P Wali
Neuropsychiatric involvement in SLE (NP-SLE) may not be picked up by routine neuroimaging procedures like computerized tomography (CT) or magnetic resonance imaging (MRI). We prospectively studied the role of single photon emission computerized tomography (SPECT) and magnetic resonance spectroscopy (MRS) in detection of NP-SLE in 20 patients with lupus (10 with clinical NP involvement and 10 without) and 9 healthy controls. MRI abnormalities were seen in 5/10 patients with NP-SLE while the MRI was normal in all the lupus patients without clinical NP involvement...
November 2003: Magnetic Resonance Imaging
J E Jennings, P C Sundgren, J Attwood, J McCune, P Maly
Our objective was to review the frequency and pattern of signal abnormalities seen on conventional MRI in patients with suspected neuropsychiatric systemic lupus erythematosus (NP-SLE). We reviewed 116 MRI examinations of the brain performed on 85 patients with SLE, (81 women, four men, aged 21-78 years, mean 40.6 years) presenting with neurological disturbances. MRI was normal or nearly normal in 34%. In 60% high-signal lesions were observed on T2-weighted images, frequently in the frontal and parietal subcortical white matter...
January 2004: Neuroradiology
S C A Steens, G P Th Bosma, R ten Cate, J Doornbos, J M Kros, L A E M Laan, G M Steup-Beekman, M A van Buchem, T W J Huizinga
BACKGROUND: The course of central nervous system systemic lupus erythematosus (CNS-SLE) is largely unknown. New imaging techniques are available to assist in monitoring the disease course. OBJECTIVE: To report a case of juvenile CNS-SLE, in which magnetic resonance imaging (MRI) was used to assess disease activity. CASE REPORT: A 10-year-old female patient with SLE presented with convulsions; MRI and computed tomography (CT) of the cerebrum disclosed abnormalities...
June 2003: Annals of the Rheumatic Diseases
M Mortilla, M Ermini, M Nistri, G Dal Pozzo, F Falcini
OBJECTIVE: The aim of the present study was to assess and monitor brain damage in patients with pediatric onset systemic lupus erythematosus (SLE) using non-invasive techniques such as magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (H-MRS). METHODS: Twenty-four SLE patients, both symptomatic or asymptomatic for central nervous system (CNS) involvement, and 20 controls were examined. Each individual underwent a diagnostic MRI using a 1...
January 2003: Clinical and Experimental Rheumatology
Stefan Markus Weiner, Andreas Otte, Markus Uhl, Ingo Brink, Martin Schumacher, Hans Hartmut Peter
BACKGROUND: The diagnosis of neuropsychiatric lupus erythematosus (NPSLE) can be difficult and has to be differentiated from neurologic complications that result from hypertension, drugs, infection, uremia, and metabolic changes. DIAGNOSTICS: There is no single test which is diagnostic. Therefore, the clinical presentation, serologic tests and neuroimaging techniques have to be combined to support the diagnosis of cerebral lupus. Magnetic resonance imaging (MRI) is routinely used with a sensitivity of 50-87%...
February 15, 2003: Medizinische Klinik
L Stojanovich, R Stojanovich, V Kostich, E Dzjolich
Sixty SLE patients with only primary neuropsychiatric manifestations (NP-SLE), (54 female and six male; mean age 44.5) were compared consecutively. Forty-six of the patients (78.3%) were presented with a combination of neuropsychiatric symptoms. Except for the standard immunoserological test, all patients underwent clinical, neurological and psychiatric examination, electrophysiological tests [EEG (electro-encephalography involves recording and analysis of electrical signals generated by the brain), EP (the evoked potentials method involves analysis of a series of electrical signals generated in parts of the nervous system following stimulation of sense organs and peripheral nerves) and EMNG (electro-myo-neography is a method of measurement of electrical activity arising from muscle fibers and peripheral nerves)]...
2003: Lupus
M Rovaris, C Pedroso, M Filippi
The detection of multisystemic involvement often leads to a correct diagnosis of the antiphospholipid syndrome (APS), even in cases with predominant neurologic manifestations. However, when central nervous system deficits are isolated and have a relapsing-remitting or a progressive course, other conditions must be carefully considered. In this context, the diagnostic accuracy of conventional magnetic resonance imaging (MRI) is hampered by its limited pathologic specificity, which is one of the reasons why no or only modest correlations have been found between the burden of MRI-visible lesions and other clinical or laboratory measures of disease severity in patients with APS...
August 2001: Current Rheumatology Reports
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