Systemic lupus erythematosus MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Joint and synovial evaluation

Reveal erosive changes and abnormalities of the soft tissues more often, including:

• Capsular swelling
• Proliferative tenosynovitis
• Synovial overgrowth

Neurological evaluation

MRI is more sensitive than CT, and may reveal the following abnormalities:

• Focal neurological defects
• White matter lesions
• Periventricular hyperintensities
• Detects clinically silent lesions

Cardialogical evaluation

• Cine cardiac MR imaging as an noninvasive tool for evaluating
  • Abnormal flow patterns
  • Ventricular dimensions
  • Stroke volume
  • Regional myocardial function

Bone evaluation

• Avascular necrosis (AVN)
  • Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging 
  • Bone marrow edema on MRI with  
  • 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 
  • 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 surface 

• 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