Detection of cerebral involvement in patients with active neuropsychiatricsystemic lupus erythematosus by the use of volumetric magnetization transfer imaging

Objective. To determine whether volumetric magnetization transfer imaging ( MTI) histogram analysis can detect abnormalities in patients with active ne uropsychiatric systemic lupus erythematosus (NPSLE) and to compare the MTI findings in patients with active NPSLE, chronic NPSLE, and multiple scleros is (MS), as well as in normal control subjects, Methods. Eight female and 1 male patient with active nonthromboembolic NPSL E (mean +/- SD age 39 +/- 9 years), 10 female patients with chronic NPSLE ( age 33 +/- 11 years), 10 female patients with SLE and no history of NPSLE ( non-NPSLE; age 34 +/- 11 years), 10 female patients with inactive MS (age 4 1 +/- 6 years), and 10 healthy control subjects (age 33 +/- 11 years) under went MTI, Using the MTI scans, histograms were composed from which we deriv ed a variety of parameters that quantitatively reflect the uniformity of th e brain parenchyma as well as the ratio of cerebrospinal fluid to intracran ial volume, which reflects atrophy. Results. The magnetization transfer ratio (MTR) histograms in the non-NPSLE group and the healthy control group were similar, whereas those in the chr onic NPSLE and MS groups were flatter. There was also flattening of the his tograms in the active NPSLE group, but with a shift toward higher MTRs, Conclusion, Our results indicate that volumetric MTI analysis detects cereb ral changes in the active phase of NPSLE, The abnormalities in the brain pa renchyma of patients with chronic NPSLE produced MTI values that were the s ame as those in patients with inactive MS, MTI values in the active phase o f NPSLE differed from those in the chronic phase, which might reflect the p resence of inflammation. These preliminary results suggest that MTI might p rovide evidence for the presence of active NPSLE, MTI might also prove to b e a valuable technique for monitoring treatment trials.