| Magnetic resonance imaging and brain histopathology in neuropsychiatric systemic lupus erythematosus. | |
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MedLine Citation:
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PMID: 19880162 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Magnetic resonance imaging (MRI) often demonstrates brain lesions in neuropsychiatric systemic lupus erythematosus (NPSLE). The present study compared postmortem histopathology with premortem MRI in NPSLE. METHODS: Two hundred subjects with NPSLE were studied prospectively with MRI over a 10-year period during which 22 subjects died. In 14 subjects, a brain autopsy with histopathology, that permitted direct comparison with premortem MRI, was successfully obtained. Surface anatomy was used to determine the approximate location of individual lesions. RESULTS: Premortem MRI findings in fatal NPSLE were small focal white matter lesions (100%), cortical atrophy (64%), ventricular dilation (57%), cerebral edema (50%), diffuse white matter abnormalities (43%), focal atrophy (36%), cerebral infarction (29%), acute leukoencephalopathy (25%), intracranial hemorrhage (21%), and calcifications (7%). Microscopic findings in fatal NPSLE included global ischemic changes (57%), parenchymal edema (50%), microhemorrhages (43%), glial hyperplasia (43%), diffuse neuronal/axonal loss (36%), resolved cerebral infarction (33%), microthomboemboli (29%), blood vessel remodeling (29%), acute cerebral infarction (14%), acute macrohemorrhages (14%), and resolved intracranial hemorrhages (7%). Cortical atrophy and ventricular dilation seen by MRI accurately predicted brain mass at autopsy (r = -0.72, P = 0.01, and r = -0.77, P = 0.01, respectively). Cerebral autopsy findings, including infarction, cerebral edema, intracranial hemorrhage, calcifications, cysts, and focal atrophy, were also predicted accurately by premortem MRI. CONCLUSION: Brain lesions in NPSLE detected by MRI accurately represent serious underlying cerebrovascular and parenchymal brain injury on pathology. |
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Authors:
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Wilmer L Sibbitt; William M Brooks; Mario Kornfeld; Blaine L Hart; Arthur D Bankhurst; Carlos A Roldan |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2009-10-31 |
Journal Detail:
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Title: Seminars in arthritis and rheumatism Volume: 40 ISSN: 1532-866X ISO Abbreviation: Semin. Arthritis Rheum. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-08-02 Completed Date: 2010-11-09 Revised Date: 2011-02-24 |
Medline Journal Info:
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Nlm Unique ID: 1306053 Medline TA: Semin Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 32-52 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Internal Medicine, Division of Clinical Immunology and Rheumatic Diseases, University of New Mexico Heath Sciences Center, Albuquerque, NM 87131, USA. wsibbitt@salud.unm.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Brain / pathology* Child Diagnosis, Differential Female Follow-Up Studies Humans Lupus Vasculitis, Central Nervous System / diagnosis* Magnetic Resonance Imaging / methods* Male Middle Aged Prospective Studies Reproducibility of Results Time Factors Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL077422-01-A3/HL/NHLBI NIH HHS; R01 NS035708/NS/NINDS NIH HHS; R01 NS039123/NS/NINDS NIH HHS |
| Comments/Corrections | |
Erratum In:
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Semin Arthritis Rheum. 2011 Feb;40(4):369 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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