MRI Study Of Water Molecule Diffusion And Cerebral Blood Flow In Patients With Non-neuropsychiatric Systemic Lupus Erythematosus

Objective: Using diffusion weighted magnetic resonance imaging(DWI)and 3D-arterial spin labeling(3D-ASL)techniques,we investigated the diffusion of water molecules and cerebral perfusion in non-neuropsychiatric systemic lupus erythematosus(non-NPSLE)patients.Neuropsychiatric systemic lupus erythematosus(non-NPSLE)patients,to clarify whether there are abnormalities in brain structure and function in non-NPSLE patients,and to explore new clinical markers for structural and functional brain alterations in non-NPSLE patients.Methods: We collected 20 patients with non-NPSLE diagnosised in our hospital and recruited 14 healthy controls(HC)matched for age,sex,and handedness to the non-NPSLE group,all subjects underwent DWI and ASL scans,and recorded general data of all subjects and clinical data of non-NPSLE patients.Clinical data,containing the latest test results of disease duration,medication duration,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),complement(C3,C4),immunoglobulins(Ig A,Ig G,Ig M),etc.were recorded.The 3D-ASL and DWI data were imported into a post-processing workstation(Philips Intelli Space Portal),and the 3D-ASL images were processed to obtain cerebral blood flow(CBF)pseudo-color maps,and the average CBF and apparent diffusion coefficient(ADC)values were measured using a rectangular measurement tool.The mean ADC and mean CBF values of bilateral frontal white matter,parietal white matter,temporal white matter,occipital white matter and cerebellar white matter were measured by rectangular measurement tool with a region of interest(ROI)size of 20 mm2,and the differences between the two groups were compared by independent two-sample test.Finally,the ADC values and CBF values of significantly abnormal brain regions in the non-NPSLE group were related to clinical parameters,respectively.Results: 1.Compared with the HC group,the ADC values in the non-NPSLE patient group showed significant differences,as showed by the significantly higher ADC values in the non-NPSLE group in the white matter of left frontal lobe,left parietal lobe,right parietal lober,left temporal lobe,right temporal lobe,and right cerebellar lobe.2.Compared with the HC group,the CBF values showed significant differences,as showed by the significant decrease in CBF values in the non-NPSLE group in the white matter of left frontal lobe,right frontal lobe,left temporal lobe,right temporal lobe,and left occipital lobe.3.In the non-NPSLE group,ADC values and CBF values of the differential brain regions were correlated with clinical parameters,showing that ADC values of left frontal white matter were negatively correlated with C3,left frontal white matter ADC value was negatively correlated with C4,left parietal white matter ADC value was negatively correlated with C4,left frontal white matter CBF value was positively correlated with C3,left frontal white matter CBF value was positively correlated with C4,left occipital white matter CBF value was positively correlated with C3,left frontal white matter ADC value was positively correlated with disease duration,right parietal white matter ADC value was positively correlated with disease duration.Conclusions: 1.Non-NPSLE patients showed significant abnormalities in brain structure and function.ADC values and CBF values may predict the possibility of extensive brain parenchymal damage in SLE patients in the future,or may be a feasible tool of monitoring disease progression,assessing treatment effects,and follow-up observations in SLE patients.2.Complement C3 and C4 are related to the occurrence of brain injury in SLE patients,which is important for further exploration of its pathogenesis,and early inhibition of complement C3 and C4 activation may be effective in preventing progression of disease.