Imaging modalities in central nervous system systemic lupus erythematosus

Within the past few years, a clearly defined case definition system for cen tral nervous system systemic lupus erythematosus (CNS-SLE) has been establi shed. This has allowed cross-study comparisons of patients fulfilling the s pecific case definitions. New imaging techniques used on the subgroup of CN S-SLE patients that did not have any evidence for infarctions suggest that in these patients symptoms are associated with a diffuse process in the bra in. Most likely this process leads to axonal damage and demyelination, ulti mately leading to cerebral atrophy. With respect to the diagnostic work-up of SLE patients with neu ro psychiatric symptoms, it has become clear that cranial magnetic resonance imaging is the technique of choice. Preliminary studies using quantitative magnetic resonance imaging techniques suggest th at patients with neuropsychiatric symptoms caused by active CNS-SLE can be differentiated from patients with the same symptoms caused by residual dise ase. (C) 2001 Lippincott Williams & Wilkins, Inc.