신경정신루푸스 에서 MRS의 조기 진단적 가치.

초록

Objective : To investigate the usefulness of H1-magnetic resonance spectroscopy(H1-MRS) for the early diagnosis of neuropsychiatric systemic lupus erythematosus(NPSLE). Methods : Magnetic resonance image (MRI) and H1-MRS were performed on fifteen normal volunteers (mean age, 29±6 years: age range, 24-40 years) and twenty seven patients with SLE : twelve (26±8 years: 16-42 years) with and fifteen (324:12 years:13-57 years) without NPSLE. The localized IH-MRS was performed by a GE 1.5T SIGNA MRl/MRS system (version 5.5) with active shielded gradients. For all spectra. A Stimulated Echo Acquisition Method(STEAM) localization sequence with three-pulse CHESS H2O suppression was used. The metabolite ratios of N-acetylaspartate (NAA) to creatine (Cr) and choline (Cho) to Cr measured on H1-MRS of the basal ganglia (BG) and peritrigonal periventricular white matter (PWM). Results: The level of disease activity maker (anti-dsDNA, C3, C4, SLEDAI score), autoantibodies (lupus anticoagulant, anti-cardiolipin antibody, anti-ribosomal-P) . and EEG did not showed significant difference between the patients without NPSLE and with NPSLE (p>0.05). Thirteen percent (2/15) of patients without NPSLE and fifty percent(6/12) of patient with the NPSLE showed abnormality in MRI. H1-MRS showed significantly decreased NAA/Cr ratio in BG and increased Cho/cr ratio in PWM for the patients with NPSLE compared to the patients without NPSLE and normal volunteers(f(0.05) . No correlation was shown between the maker of disease activity and NAA/Cr in BG or Cho/cr ratio in PWM in the SLE group(p>0.05). But negative correlation was shown between NAA/Cr in BG and Cho/cr ratio in PWM (r= -0.58, p<0.05). Conclusion : NAA/Cr ratio in BG was decreased and Cho/cr in PWM was increased in NPSLE. The neurormetabolite ratio measured by H1-MRS may be useful in the early detection of NPSLE.