Systemic lupus erythematosus MRI: Difference between revisions
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==Overview== | ==Overview== | ||
On abdominal MRI, systemic lupus erythematosus (SLE) may be characterized by hepatomegaly, pancreatic parenchymal enlargement, and hypervascularity of mesentery. On cardiac MRI, SLE may be characterized by mitral leaflet thickening, pericardial thickness, and pericardial effusions. On brain MRI, SLE may be characterized by white matter lesions, changes in blood circulation of the brain, and patchy areas of enhancement. On musculoskeletal MRI, SLE may be characterized by intramuscular edema, [[Tenosynovitis|proliferative tenosynovitis]], and [[bone marrow]] edema. | On [[MRI|abdominal MRI]], systemic lupus erythematosus (SLE) may be characterized by [[hepatomegaly]], [[Pancreas|pancreatic]] parenchymal enlargement, and hypervascularity of [[mesentery]]. On [[cardiac MRI]], SLE may be characterized by mitral leaflet thickening, pericardial thickness, and [[Pericardial effusion|pericardial effusions]]. On brain MRI, SLE may be characterized by white matter lesions, changes in blood circulation of the brain, and patchy areas of enhancement. On musculoskeletal MRI, SLE may be characterized by [[intramuscular]] [[edema]], [[Tenosynovitis|proliferative tenosynovitis]], and [[bone marrow]] [[edema]]. | ||
== Key MRI findings in systemic lupus erythematosus == | == Key MRI findings in systemic lupus erythematosus == | ||
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* [[Hepatomegaly]] | * [[Hepatomegaly]] | ||
* Nodules that ranging around 0.5-4.5 cm in diameter | * [[Nodules]] that ranging around 0.5-4.5 cm in diameter | ||
** T2: nonspecific, increased periportal edema | ** T2: nonspecific, increased periportal [[edema]] | ||
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|[[Acute pancreatitis]] | |[[Acute pancreatitis]] | ||
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* Contrast-enhanced MR is equivalent to CT in the assessment of pancreatitis | * Contrast-enhanced MR is equivalent to CT in the assessment of [[pancreatitis]] | ||
** Abnormalities that may be seen in the pancreas include: | ** Abnormalities that may be seen in the pancreas include: | ||
*** Parenchymal enlargement | *** Parenchymal enlargement | ||
*** Surrounding retroperitoneal fat stranding | *** Surrounding [[retroperitoneal]] fat stranding | ||
*** Abscess formation | *** [[Abscess]] formation | ||
**** Circumscribed fluid collection | **** Circumscribed fluid collection | ||
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* Comb sign | * Comb sign | ||
** Hypervascular appearance of the | ** Hypervascular appearance of the [[mesentery]] | ||
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| rowspan="4" |Cardiac involvement | | rowspan="4" |Cardiac involvement | ||
|[[Mitral stenosis]] | |[[Mitral stenosis]] | ||
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* Mitral leaflet thickening | * [[Mitral valve sclerosis|Mitral leaflet thickening]] | ||
* Reduced diastolic opening | * Reduced [[diastolic]] opening | ||
* Abnormal valve motion toward the left ventricular outflow tract | * Abnormal valve motion toward the [[Left ventricle|left ventricular]] outflow tract | ||
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|[[Pericarditis|Acute pericarditis]] | |[[Pericarditis|Acute pericarditis]] | ||
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* The normal pericardial thickness is considered 2 mm while a thickness of over 4 mm suggests a [[pericarditis]] | * The normal [[pericardial]] thickness is considered 2 mm while a thickness of over 4 mm suggests a [[pericarditis]] | ||
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|[[Pericardial effusion]] | |[[Pericardial effusion]] | ||
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* Regional or global wall motion abnormalities | * Regional or global wall motion abnormalities | ||
* Pericardial effusion | * [[Pericardial effusion]] | ||
** Early postcontrast enhancement due to regional vasodilatation and increased blood volume, secondary to the inflammation | ** Early postcontrast enhancement due to regional vasodilatation and increased blood volume, secondary to the [[inflammation]] | ||
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| rowspan="4" |Neurological involvement | | rowspan="4" |Neurological involvement | ||
|General | |General | ||
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* Focal neurological defects | * [[Focal neurologic signs|Focal neurological defects]] | ||
* White matter lesions | * [[White matter]] [[lesions]] | ||
* Periventricular hyperintensities | * [[Periventricular nucleus|Periventricular]] hyperintensities | ||
* Detects clinically silent lesions | * Detects clinically silent lesions | ||
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* No parenchymal changes | * No parenchymal changes | ||
* Slow or stagnant flow in vessels as a loss of normal flow void | * Slow or stagnant flow in vessels as a loss of normal flow void | ||
* High T2 signal after 6 hours of | * High T2 signal after 6 hours of [[stroke]] | ||
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|[[Neuropathies]] | |[[Neuropathies]] | ||
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* [[Optic neuritis]] | * [[Optic neuritis]] | ||
** Retrobulbar intra-orbital segment of the optic nerve appears swollen | ** [[Retrobulbar block|Retrobulbar]] intra-orbital segment of the [[optic nerve]] appears swollen | ||
*** High T2 signal that may persists and be permanent | *** High T2 signal that may persists and be permanent | ||
** Chronic involvement of optic nerve | ** Chronic involvement of [[optic nerve]] | ||
*** Atrophied nerve | *** [[Atrophy|Atrophied]] nerve | ||
*** Contrast enhancement of the nerve, best seen with fat-suppressed T1 coronal images | *** Contrast enhancement of the nerve, best seen with fat-suppressed T1 coronal images | ||
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|Autoimmune encephalitis | |[[Encephalitis|Autoimmune encephalitis]] | ||
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* Mostly in temporal | * Mostly in [[temporal lobe]]<nowiki/>s and [[Limbic system|limbic systems]] | ||
* Bilateral involvement is most common (60%), although often asymmetric | * Bilateral involvement is most common (60%), although often asymmetric | ||
* [[Cortical area|Cortical]] thickening | * [[Cortical area|Cortical]] thickening | ||
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| rowspan="4" |Musculoskeletal involvement | | rowspan="4" |Musculoskeletal involvement | ||
|Raynaud phenomen | |[[Raynaud phenomenon|Raynaud phenomen]] | ||
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* Contrast-enhanced MR angiograph | * Contrast-enhanced [[MR angiography|MR angiograph]] | ||
** Characteristic narrowing of digital vessels | ** Characteristic narrowing of digital [[vessels]] | ||
** Tapering of digital vessels | ** Tapering of digital [[vessels]] | ||
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|Myositis | |[[Myositis]] | ||
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* Intramuscular | * [[Edema|Intramuscular edema]] (increased high T2 signal) | ||
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|[[Arthritis]] | |[[Arthritis]] | ||
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* Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging | * Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging | ||
* Bone marrow edema on MRI | * [[Bone marrow]] [[edema]] on MRI | ||
* Low-signal-intensity marginal areas on standard spin-echo T1- and T2-weighted images | * Low-signal-intensity marginal areas on standard spin-echo T1- and T2-weighted images | ||
* Intermediate to high signal intensity inside bone tissue on T2-weighted images, producing a line of low signal intensity with an adjacent high-signal-intensity line | * Intermediate to high signal intensity inside bone tissue on T2-weighted images, producing a line of low signal intensity with an adjacent high-signal-intensity line | ||
* High signal intensity on T2-weighted images due to subchondral fractures that may be accompanied by fluid signal intensity or | * High signal intensity on T2-weighted images due to subchondral fractures that may be accompanied by fluid signal intensity or [[edema]] | ||
* Low signal intensity on T2-weighted images due to collapse of the articular | * Low signal intensity on T2-weighted images due to collapse of the [[articular surface]] | ||
* Early or subtle insufficiency fractures especially on T2-weighted MR imaging | * Early or subtle insufficiency fractures especially on T2-weighted MR imaging | ||
** In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to bone marrow edema | ** In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to [[bone marrow]] edema | ||
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Revision as of 16:27, 26 July 2017
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Systemic lupus erythematosus Microchapters |
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Differentiating Systemic lupus erythematosus from other Diseases |
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Case Studies |
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Systemic lupus erythematosus MRI On the Web |
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American Roentgen Ray Society Images of Systemic lupus erythematosus MRI |
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Directions to Hospitals Treating Systemic lupus erythematosus |
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Risk calculators and risk factors for Systemic lupus erythematosus MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
On abdominal MRI, systemic lupus erythematosus (SLE) may be characterized by hepatomegaly, pancreatic parenchymal enlargement, and hypervascularity of mesentery. On cardiac MRI, SLE may be characterized by mitral leaflet thickening, pericardial thickness, and pericardial effusions. On brain MRI, SLE may be characterized by white matter lesions, changes in blood circulation of the brain, and patchy areas of enhancement. On musculoskeletal MRI, SLE may be characterized by intramuscular edema, proliferative tenosynovitis, and bone marrow edema.
Key MRI findings in systemic lupus erythematosus
Most of the SLE complications can be visualized with other more feasible imaging techniques. So, MRI is not the imaging modality of choice for the diagnosis of most complications of SLE, but if done, the following changes can be found in different organ systems of the body:
| Disease | MRI | |
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| Gastrointestinal system | Hepatitis |
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| Acute pancreatitis |
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| Mesenteric vasculitis |
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| Cardiac involvement | Mitral stenosis |
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| Acute pericarditis |
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| Pericardial effusion |
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| Myocarditis |
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| Neurological involvement | General |
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| Stroke |
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| Neuropathies |
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| Autoimmune encephalitis |
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| Musculoskeletal involvement | Raynaud phenomen |
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| Myositis |
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| Arthritis |
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| Osteonecrosis (Avascular necrosis) |
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