Evaluation value of magnetic resonance diffusion tensor imaging for cerebrovascular small vessel disease in patients with systemic lupus erythematosus
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目的 探讨磁共振弥散张量成像（DTI）对系统性红斑狼疮（SLE）患者脑小血管病（CSVD）的评估价值。 方法 采用前瞻性研究的方法，选择宜兴市人民医院2022年1—12月治疗的SLE合并CSVD患者82例，根据常规MRI检查结果分为急性期梗死组（16例）、慢性期梗死组（26例）和慢性缺血灶组（40例），所有患者均行DTI检查，获取患侧及对侧正常脑白质区的平均弥散系数（DCavg）和各向异性分数（FA），分析DTI对SLE患者CSVD的评估价值。 结果 82例患者病灶患侧DCavg显著高于健侧[（11.10 ± 3.48）10-3 mm2/s比（8.18 ± 2.42）10-3 mm2/s]，患侧FA显著低于健侧（0.28 ± 0.05比0.45 ± 0.08），差异有统计学意义（P<0.05）。急性梗死期组、慢性期梗死组、慢性缺血灶组DCavg分别为（11.88 ± 3.50）、（9.69 ± 3.24）和（8.52 ± 2.34）10-3 mm2/s，差异有统计学意义（P<0.05）；急性梗死期组、慢性期梗死组、慢性缺血灶组FA分别为0.28 ± 0.04、0.33 ± 0.06和0.40 ± 0.07，差异有统计学意义（P<0.05）。绘制受试者工作特征曲线，结果显示，DCavg、FA单独及联合评估急性期梗死组和慢性期梗死组的曲线下面积（AUC）分别为0.757、0.756和0.820，评估慢性期梗死组和慢性缺血灶组的AUC分别为0.772、0.776和0.813，联合评估的AUC值相对较大。 结论 DTI对SLE患者CSVD具有良好的评估价值，可准确判断CSVD类型。 Objective To explore the value of magnetic resonance diffusion tensor imaging (DTI) in evaluating cerebrovascular small vessel disease (CSVD) in patients with systemic lupus erythematosus (SLE). Methods Eighty-two patients with SLE combined with CSVD treated at Yixing People's Hospital from January to December 2022 were selected. They were divided into acute phase infarction group (16 cases), chronic phase infarction group (26 cases), and chronic ischemic lesion group (40 cases) based on routine MRI examination results. All patients underwent DTI examination to obtain the average diffusion coefficient (DCavg) and anisotropy score (FA) of the affected and contralateral normal white matter areas, and the evaluation value of DTI for CSVD in SLE patients was analyzed. Results The DCavg value on the affected side of 82 patients was significantly higher than that on the healthy side: (11.10 ± 3.48) 10-3 mm2/s vs. (8.18 ± 2.42) 10-3 mm2/s, and the FA value on the affected side was significantly lower than that on the healthy side: 0.28 ± 0.05 vs. 0.45 ± 0.08, with a statistical significant differences (P<0.05). The DCavg values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were (11.88 ± 3.50), (9.69 ± 3.24) and (8.52 ± 2.34) 10-3 mm2/s, respectively, with statistical significant differences (P<0.05). The FA values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were 0.28 ± 0.04, 0.33 ± 0.06 and 0.40 ± 0.07, respectively, with statistical significant differences (P<0.05). The receiver operating characteristic curve was drawn, and the results showed that the area under the curve (AUC) of the acute phase infarction group and the chronic phase infarction group evaluated by DCavg and FA alone and in combination were 0.757, 0.756, and 0.820, respectively. The AUC of the chronic phase infarction group and the chronic ischemic focus group evaluated by DCavg and FA were 0.772, 0.776, and 0.813, respectively. The AUC value of the combined evaluation was relatively large. Conclusions DTI has good evaluation value for CSVD in SLE patients and can accurately determine the type of CSVD.
Objective To explore the value of magnetic resonance diffusion tensor imaging (DTI) in evaluating cerebrovascular small vessel disease (CSVD) in patients with systemic lupus erythematosus (SLE). Methods Eighty-two patients with SLE combined with CSVD treated at Yixing People's Hospital from January to December 2022 were selected. They were divided into acute phase infarction group (16 cases), chronic phase infarction group (26 cases), and chronic ischemic lesion group (40 cases) based on routine MRI examination results. All patients underwent DTI examination to obtain the average diffusion coefficient (DCavg) and anisotropy score (FA) of the affected and contralateral normal white matter areas, and the evaluation value of DTI for CSVD in SLE patients was analyzed. Results The DCavg value on the affected side of 82 patients was significantly higher than that on the healthy side: (11.10 ± 3.48) 10-3 mm2/s vs. (8.18 ± 2.42) 10-3 mm2/s, and the FA value on the affected side was significantly lower than that on the healthy side: 0.28 ± 0.05 vs. 0.45 ± 0.08, with a statistical significant differences (P<0.05). The DCavg values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were (11.88 ± 3.50), (9.69 ± 3.24) and (8.52 ± 2.34) 10-3 mm2/s, respectively, with statistical significant differences (P<0.05). The FA values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were 0.28 ± 0.04, 0.33 ± 0.06 and 0.40 ± 0.07, respectively, with statistical significant differences (P<0.05). The receiver operating characteristic curve was drawn, and the results showed that the area under the curve (AUC) of the acute phase infarction group and the chronic phase infarction group evaluated by DCavg and FA alone and in combination were 0.757, 0.756, and 0.820, respectively. The AUC of the chronic phase infarction group and the chronic ischemic focus group evaluated by DCavg and FA were 0.772, 0.776, and 0.813, respectively. The AUC value of the combined evaluation was relatively large. Conclusions DTI has good evaluation value for CSVD in SLE patients and can accurately determine the type of CSVD.
Lupus erythematosus, systemicCerebrovascular small vessel diseaseMagnetic resonance imagingDiffusion tensor imaging
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