Systemic lupus erythematosus MRI: Difference between revisions

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Latest revision as of 16:21, 1 February 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mahshid Mir, M.D. [2]

Overview

On abdominal MRI, systemic lupus erythematosus (SLE) may be characterized by hepatomegaly, pancreatic parenchymal enlargement, and hypervascularity of mesentery. On cardiac MRI, SLE may be characterized by mitral leaflet thickening, pericardial thickness, and pericardial effusions. On brain MRI, SLE may be characterized by white matter lesions, changes in blood circulation of the brain, and patchy areas of enhancement. On musculoskeletal MRI, SLE may be characterized by intramuscular edema, proliferative tenosynovitis, and bone marrow edema.

Key MRI findings in systemic lupus erythematosus

Most of SLEs complications can be visualized with other, more feasible imaging techniques, so MRI is not the imaging modality of choice for the diagnosis of most complications of SLE. However, if it is done, the following changes can be found in different organ systems of the body:^[1]^[2]^[3]^[4]^[5]^[6]^[7]^[8]^[9]^[10]^[11]

Organ involvement	Disease	MRI	Preview
Gastrointestinal	Hepatitis	Hepatomegaly Nodules that ranging around 0.5-4.5 cm in diameter T2: nonspecific, increased periportal edema	Adapted from Radiopaedia Adapted from Radiopaedia
	Cholecystitis	Pericholecystic fluid Gall bladder wall thickening Usually present as acalculus cholecystitis	Courtesy given to ACG Case Reports
	Pancreatitis	Contrast-enhanced MR is equivalent to CT in the assessment of pancreatitis Abnormalities that may be seen in the pancreas include: Parenchymal enlargement Surrounding retroperitoneal fat stranding Abscess formation Circumscribed fluid collection	Adapted from Radiopaedia
	Mesenteric vasculitis	Comb sign Hypervascular appearance of the mesentery
Cardiac	Mitral stenosis	Mitral leaflet thickening Reduced diastolic opening Abnormal valve motion toward the left ventricular outflow tract
	Pericarditis	The normal pericardial thickness is considered 2 mm while a thickness of over 4 mm suggests a pericarditis Delayed enhancement in the pericardium around heart chambers	Adapted from Radiopaedia
	Pericardial effusion	Fluid density material surrounding the heart
	Myocarditis	Regional or global wall motion abnormalities Pericardial effusion Early postcontrast enhancement due to regional vasodilatation and increased blood volume, secondary to the inflammation	Adapted from Radiopaedia
Neurological	Vasculitis	White matter lesions Periventricular hyperintensities Detects clinically silent lesions	Adapted from Radiopaedia
	Stroke	Changes in brain vessel blood flow (occlusion on MRA) No parenchymal changes Slow or stagnant flow in vessels as a loss of normal flow void High T2 signal after 6 hours of stroke	Adapted from Radiopaedia
	Neuropathies	Optic neuritis Retrobulbar intra-orbital segment of the optic nerve appears swollen High T2 signal that may persists and be permanent Chronic involvement of optic nerve Atrophied nerve Contrast enhancement of the nerve, best seen with fat-suppressed T1 coronal images	Adapted from Radiopaedia Adapted from Radiopaedia
	Autoimmune encephalitis	Mostly in temporal lobes and limbic systems Bilateral involvement is most common (60%), although often asymmetric Cortical thickening Increased T2/FLAIR signal intensity of affected regions Patchy areas of enhancement	Adapted from Radiopaedia
Musculoskeletal	Raynaud phenomen	Contrast-enhanced MR angiograph Characteristic narrowing of digital vessels Tapering of digital vessels	Adapted from Radiopaedia
	Myositis	Intramuscular edema (increased high T2 signal) May show an ill-defined, hyperintense, intramuscular lesion, containing isointense lines	Adapted from Radiopaedia
	Arthritis/tenosynovitis	Capsular swelling Proliferative tenosynovitis Synovial overgrowth	Adapted from Radiopaedia
	Osteonecrosis (Avascular necrosis)	Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging Bone marrow edema on MRI Low-signal-intensity marginal areas on standard spin-echo T1- and T2-weighted images Intermediate to high signal intensity inside bone tissue on T2-weighted images, producing a line of low signal intensity with an adjacent high-signal-intensity line High signal intensity on T2-weighted images due to subchondral fractures that may be accompanied by fluid signal intensity or edema Low signal intensity on T2-weighted images due to collapse of the articular surface Early or subtle insufficiency fractures especially on T2-weighted MR imaging In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to bone marrow edema	Adapted from Radiopaedia Adapted from Radiopaedia

References

↑ Appenzeller S (2013). "Magnetic resonance imaging in systemic lupus erythematosus: where do we stand?". Cogn Behav Neurol. 26 (2): 53–4. doi:10.1097/WNN.0b013e31829d5b60. PMID 23812167.
↑ Thurman JM, Serkova NJ (2015). "Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus". F1000Res. 4: 153. doi:10.12688/f1000research.6587.2. PMC 4536614. PMID 26309728.
↑ Lin K, Lloyd-Jones DM, Li D, Liu Y, Yang J, Markl M, Carr JC (2015). "Imaging of cardiovascular complications in patients with systemic lupus erythematosus". Lupus. 24 (11): 1126–34. doi:10.1177/0961203315588577. PMC 4567427. PMID 26038342.
↑ Sarbu N, Bargalló N, Cervera R (2015). "Advanced and Conventional Magnetic Resonance Imaging in Neuropsychiatric Lupus". F1000Res. 4: 162. doi:10.12688/f1000research.6522.2. PMC 4505788. PMID 26236469.
↑ Qin H, Guo Q, Shen N, Huang X, Wu H, Zhang M, Bao C, Chen S (2014). "Chest imaging manifestations in lupus nephritis". Clin. Rheumatol. 33 (6): 817–23. doi:10.1007/s10067-014-2586-2. PMID 24696368.
↑ Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part II: gastrointestinal, renal, and musculoskeletal manifestations". Clin Radiol. 68 (2): 192–202. doi:10.1016/j.crad.2012.06.109. PMID 22901453.
↑ Gal Y, Twig G, Mozes O, Greenberg G, Hoffmann C, Shoenfeld Y (2013). "Central nervous system involvement in systemic lupus erythematosus: an imaging challenge". Isr. Med. Assoc. J. 15 (7): 382–6. PMID 23943987.
↑ Shirato M, Hisa N, Fujikura Y, Ohkuma K, Kutsuki S, Hiramatsu K (1992). "[Imaging diagnosis of lupus enteritis--especially about sonographic findings]". Nihon Igaku Hoshasen Gakkai Zasshi (in Japanese). 52 (10): 1394–9. PMID 1448334.
↑ Adachi JD, Lau A (2014). "Systemic lupus erythematosus, osteoporosis, and fractures". J. Rheumatol. 41 (10): 1913–5. doi:10.3899/jrheum.140919. PMID 25275093.
↑ Curiel R, Akin EA, Beaulieu G, DePalma L, Hashefi M (2011). "PET/CT imaging in systemic lupus erythematosus". Ann. N. Y. Acad. Sci. 1228: 71–80. doi:10.1111/j.1749-6632.2011.06076.x. PMID 21718325.
↑ Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part I: CNS, cardiovascular, and thoracic manifestations". Clin Radiol. 68 (2): 181–91. doi:10.1016/j.crad.2012.06.110. PMID 22901452.

Template:WH Template:WS

[pmid23812167-1] Appenzeller S (2013). "Magnetic resonance imaging in systemic lupus erythematosus: where do we stand?". Cogn Behav Neurol. 26 (2): 53–4. doi:10.1097/WNN.0b013e31829d5b60. PMID 23812167.

[pmid26309728-2] Thurman JM, Serkova NJ (2015). "Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus". F1000Res. 4: 153. doi:10.12688/f1000research.6587.2. PMC 4536614. PMID 26309728.

[pmid26038342-3] Lin K, Lloyd-Jones DM, Li D, Liu Y, Yang J, Markl M, Carr JC (2015). "Imaging of cardiovascular complications in patients with systemic lupus erythematosus". Lupus. 24 (11): 1126–34. doi:10.1177/0961203315588577. PMC 4567427. PMID 26038342.

[pmid26236469-4] Sarbu N, Bargalló N, Cervera R (2015). "Advanced and Conventional Magnetic Resonance Imaging in Neuropsychiatric Lupus". F1000Res. 4: 162. doi:10.12688/f1000research.6522.2. PMC 4505788. PMID 26236469.

[pmid24696368-5] Qin H, Guo Q, Shen N, Huang X, Wu H, Zhang M, Bao C, Chen S (2014). "Chest imaging manifestations in lupus nephritis". Clin. Rheumatol. 33 (6): 817–23. doi:10.1007/s10067-014-2586-2. PMID 24696368.

[pmid22901453-6] Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part II: gastrointestinal, renal, and musculoskeletal manifestations". Clin Radiol. 68 (2): 192–202. doi:10.1016/j.crad.2012.06.109. PMID 22901453.

[pmid23943987-7] Gal Y, Twig G, Mozes O, Greenberg G, Hoffmann C, Shoenfeld Y (2013). "Central nervous system involvement in systemic lupus erythematosus: an imaging challenge". Isr. Med. Assoc. J. 15 (7): 382–6. PMID 23943987.

[pmid1448334-8] Shirato M, Hisa N, Fujikura Y, Ohkuma K, Kutsuki S, Hiramatsu K (1992). "[Imaging diagnosis of lupus enteritis--especially about sonographic findings]". Nihon Igaku Hoshasen Gakkai Zasshi (in Japanese). 52 (10): 1394–9. PMID 1448334.

[pmid25275093-9] Adachi JD, Lau A (2014). "Systemic lupus erythematosus, osteoporosis, and fractures". J. Rheumatol. 41 (10): 1913–5. doi:10.3899/jrheum.140919. PMID 25275093.

[pmid21718325-10] Curiel R, Akin EA, Beaulieu G, DePalma L, Hashefi M (2011). "PET/CT imaging in systemic lupus erythematosus". Ann. N. Y. Acad. Sci. 1228: 71–80. doi:10.1111/j.1749-6632.2011.06076.x. PMID 21718325.

[pmid22901452-11] Goh YP, Naidoo P, Ngian GS (2013). "Imaging of systemic lupus erythematosus. Part I: CNS, cardiovascular, and thoracic manifestations". Clin Radiol. 68 (2): 181–91. doi:10.1016/j.crad.2012.06.110. PMID 22901452.

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@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Systemic lupus erythematosus}}
-{{CMG}}
+{{CMG}} {{AE}} {{MIR}}
 ==Overview==
-magnetic resonance imaging (MRI), more often reveal erosive changes and abnormalities of the soft tissues, including capsular swelling, proliferative tenosynovitis, and synovial overgrowth
+On [[MRI|abdominal MRI]], systemic lupus erythematosus (SLE) may be characterized by [[hepatomegaly]], [[Pancreas|pancreatic]] parenchymal enlargement, and hypervascularity of [[mesentery]]. On [[cardiac MRI]], SLE may be characterized by mitral leaflet thickening, pericardial thickness, and [[Pericardial effusion|pericardial effusions]]. On brain [[MRI]], SLE may be characterized by [[white matter]] [[Lesion|lesions]], changes in [[blood circulation]] of the brain, and patchy areas of enhancement. On musculoskeletal [[MRI]], SLE may be characterized by [[intramuscular]] [[edema]], [[Tenosynovitis|proliferative tenosynovitis]], and [[bone marrow]] [[edema]].
-neurological
+== Key MRI findings in systemic lupus erythematosus ==
+Most of SLEs complications can be visualized with other, more feasible imaging techniques, so MRI is not the imaging modality of choice for the diagnosis of most complications of SLE. However, if it is done, the following changes can be found in different organ systems of the body:<ref name="pmid23812167">{{cite journal |vauthors=Appenzeller S |title=Magnetic resonance imaging in systemic lupus erythematosus: where do we stand? |journal=Cogn Behav Neurol |volume=26 |issue=2 |pages=53–4 |year=2013 |pmid=23812167 |doi=10.1097/WNN.0b013e31829d5b60 |url=}}</ref><ref name="pmid26309728">{{cite journal |vauthors=Thurman JM, Serkova NJ |title=Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus |journal=F1000Res |volume=4 |issue= |pages=153 |year=2015 |pmid=26309728 |pmc=4536614 |doi=10.12688/f1000research.6587.2 |url=}}</ref><ref name="pmid26038342">{{cite journal |vauthors=Lin K, Lloyd-Jones DM, Li D, Liu Y, Yang J, Markl M, Carr JC |title=Imaging of cardiovascular complications in patients with systemic lupus erythematosus |journal=Lupus |volume=24 |issue=11 |pages=1126–34 |year=2015 |pmid=26038342 |pmc=4567427 |doi=10.1177/0961203315588577 |url=}}</ref><ref name="pmid26236469">{{cite journal |vauthors=Sarbu N, Bargalló N, Cervera R |title=Advanced and Conventional Magnetic Resonance Imaging in Neuropsychiatric Lupus |journal=F1000Res |volume=4 |issue= |pages=162 |year=2015 |pmid=26236469 |pmc=4505788 |doi=10.12688/f1000research.6522.2 |url=}}</ref><ref name="pmid24696368">{{cite journal |vauthors=Qin H, Guo Q, Shen N, Huang X, Wu H, Zhang M, Bao C, Chen S |title=Chest imaging manifestations in lupus nephritis |journal=Clin. Rheumatol. |volume=33 |issue=6 |pages=817–23 |year=2014 |pmid=24696368 |doi=10.1007/s10067-014-2586-2 |url=}}</ref><ref name="pmid22901453">{{cite journal |vauthors=Goh YP, Naidoo P, Ngian GS |title=Imaging of systemic lupus erythematosus. Part II: gastrointestinal, renal, and musculoskeletal manifestations |journal=Clin Radiol |volume=68 |issue=2 |pages=192–202 |year=2013 |pmid=22901453 |doi=10.1016/j.crad.2012.06.109 |url=}}</ref><ref name="pmid23943987">{{cite journal |vauthors=Gal Y, Twig G, Mozes O, Greenberg G, Hoffmann C, Shoenfeld Y |title=Central nervous system involvement in systemic lupus erythematosus: an imaging challenge |journal=Isr. Med. Assoc. J. |volume=15 |issue=7 |pages=382–6 |year=2013 |pmid=23943987 |doi= |url=}}</ref><ref name="pmid1448334">{{cite journal |vauthors=Shirato M, Hisa N, Fujikura Y, Ohkuma K, Kutsuki S, Hiramatsu K |title=[Imaging diagnosis of lupus enteritis--especially about sonographic findings] |language=Japanese |journal=Nihon Igaku Hoshasen Gakkai Zasshi |volume=52 |issue=10 |pages=1394–9 |year=1992 |pmid=1448334 |doi= |url=}}</ref><ref name="pmid25275093">{{cite journal |vauthors=Adachi JD, Lau A |title=Systemic lupus erythematosus, osteoporosis, and fractures |journal=J. Rheumatol. |volume=41 |issue=10 |pages=1913–5 |year=2014 |pmid=25275093 |doi=10.3899/jrheum.140919 |url=}}</ref><ref name="pmid21718325">{{cite journal |vauthors=Curiel R, Akin EA, Beaulieu G, DePalma L, Hashefi M |title=PET/CT imaging in systemic lupus erythematosus |journal=Ann. N. Y. Acad. Sci. |volume=1228 |issue= |pages=71–80 |year=2011 |pmid=21718325 |doi=10.1111/j.1749-6632.2011.06076.x |url=}}</ref><ref name="pmid22901452">{{cite journal |vauthors=Goh YP, Naidoo P, Ngian GS |title=Imaging of systemic lupus erythematosus. Part I: CNS, cardiovascular, and thoracic manifestations |journal=Clin Radiol |volume=68 |issue=2 |pages=181–91 |year=2013 |pmid=22901452 |doi=10.1016/j.crad.2012.06.110 |url=}}</ref>
+{| class="wikitable"
+! style="background: #4479BA; color: #FFFFFF; " |Organ involvement
+! style="background: #4479BA; color: #FFFFFF; " |Disease
+! style="background: #4479BA; color: #FFFFFF; " |MRI
+! style="background: #4479BA; color: #FFFFFF; " |Preview
+|-
+| rowspan="4" style="background: #DCDCDC; " |<small><small>[[Gastrointestinal]]</small></small>
+![[Hepatitis]]
+|
+* [[Hepatomegaly]]
+* [[Nodules]] that ranging around 0.5-4.5 cm in diameter
+** T2: nonspecific, increased periportal [[edema]]
+|
+[[File:Webp.net-gifmaker (29).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
-MRI is more sensitive than CT, and may reveal abnormalities that reflect focal neuropsychiatric lupus [39-41]. However, MRI may also reveal white matter lesions or periventricular hyperintensities in patients with SLE who do not have neuropsychiatric symptoms [42]. These white matter abnormalities may be difficult to interpret since they are present in 20 percent of the population younger than age 50, and in 90 percent of people older than age 70 [6,41].
+[[File:Webp.net-gifmaker (30).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Cholecystitis]]
+|
+* Pericholecystic fluid
+* [[Gallbladder|Gall bladder]] wall thickening
+*Usually present as acalculus cholecystitis
+|
+[[File:Webp.net-gifmaker (31).gif|thumb|300px|<SMALL><SMALL>''[https://acgcasereports.gi.org/acalculous-cholecystitis/ Courtesy given to ACG Case Reports]''</SMALL></SMALL>]]
+|-
+![[Acute pancreatitis|Pancreatitis]]
+|
+* Contrast-enhanced MR is equivalent to CT in the assessment of [[pancreatitis]]
+** Abnormalities that may be seen in the pancreas include:
+*** Parenchymal enlargement
+*** Surrounding [[retroperitoneal]] fat stranding
+*** [[Abscess]] formation
+**** Circumscribed fluid collection
+|
+[[File:Webp.net-geifmaker.gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Mesenteric vascular occlusion|Mesenteric vasculitis]]
+|
+* Comb sign
+** Hypervascular appearance of the [[mesentery]]
+|
+|-
+| rowspan="4" style="background: #DCDCDC; " |<small><small>[[Cardiac]]</small></small>
+![[Mitral stenosis]]
+|
+* [[Mitral valve sclerosis|Mitral leaflet thickening]]
+* Reduced [[diastolic]] opening
+* Abnormal valve motion toward the [[Left ventricle|left ventricular]] outflow tract
+|
+|-
+![[Pericarditis|Pericarditis]]
+|
+* The normal [[pericardial]] thickness is considered 2 mm while a thickness of over 4 mm suggests a [[pericarditis]]
+* Delayed enhancement in the pericardium around heart chambers
+|
+[[File:Jjjkjgh.jpeg|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Pericardial effusion]]
+|
+* Fluid [[density]] material surrounding the heart
+|
+|-
+![[Myocarditis]]
+|
+* Regional or global wall motion abnormalities
+* [[Pericardial effusion]]
+** Early postcontrast enhancement due to regional vasodilatation and increased blood volume, secondary to the [[inflammation]]
+|
+[[File:Lymphocytic-myocarditis.jpg|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+| rowspan="4" style="background: #DCDCDC; " |<small><small>[[Neurological ]]</small></small>
+!Vasculitis
+|
+* [[White matter]] [[lesions]]
+* [[Periventricular nucleus|Periventricular]] hyperintensities
+* Detects clinically silent [[Lesion|lesions]]
+|
+[[File:675765765.gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Stroke]]
+|
+* Changes in brain [[Vessels|vessel]] blood flow (occlusion on [[Magnetic resonance angiography|MRA]])
+* No parenchymal changes
+* Slow or stagnant flow in vessels as a loss of normal flow void
+* High T2 signal after 6 hours of [[stroke]]
+|
+[[File:Webp.net-kkkkgifmaker (1).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Neuropathies]]
+|
+* [[Optic neuritis]]
+** [[Retrobulbar block|Retrobulbar]] intra-orbital segment of the [[optic nerve]] appears swollen
+*** High T2 signal that may persists and be permanent
+** Chronic involvement of [[optic nerve]]
+*** [[Atrophy|Atrophied]] nerve
+*** Contrast enhancement of the [[nerve]], best seen with fat-suppressed T1 coronal images
+|
+[[File:Hkjhkjhkjhkj.gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
-MRI is the most useful neuroimaging study in patients with SLE, particularly in those with focal neurologic defects, seizures, chronic cognitive dysfunction, or the antiphospholipid syndrome and neurologic dysfunction [38]; it is less useful in patients with affective disorders, confusional states, or headache. Although MRI frequently detects clinically silent lesions, we have found the correlation with neuropsychiatric symptoms to be quite good.
+[[File:Webp.net-gjjjifmaker (2).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
-* Cine cardiac MR imaging is a useful noninvasive tool for evaluating abnormal flow patterns, ventricular dimensions, stroke volume, and regional myocardial function, but echocardiography is essential for evaluating valvular disease
+|-
+![[Encephalitis|Autoimmune encephalitis]]
+|
+* Mostly in [[temporal lobe]]<nowiki/>s and [[Limbic system|limbic systems]]
+* Bilateral involvement is most common (60%), although often asymmetric
+* [[Cortical area|Cortical]] thickening
+* Increased T2/FLAIR signal intensity of affected regions
+* Patchy areas of enhancement
+|
+[[File:Webp.net-glkjlifmaker (3).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+| rowspan="4" style="background: #DCDCDC; " |<small><small>[[Musculoskeletal]]</small></small>
+![[Raynaud phenomenon|Raynaud phenomen]]
+|
+* Contrast-enhanced [[MR angiography|MR angiograph]]
+** Characteristic narrowing of digital [[vessels]]
+** Tapering of digital [[vessels]]
+|
+[[File:Webp.net-gifkjhkumaker (4).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Myositis]]
+|
+* [[Edema|Intramuscular edema]] (increased high T2 signal)
+* May show an ill-defined, [[hyperintense]], intramuscular lesion, containing isointense lines
+|
+[[File:Webp.net-gifegtrsmaker (5).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Arthritis]]/[[tenosynovitis]]
+|
+* Capsular swelling
+* [[Tenosynovitis|Proliferative tenosynovitis]]
+* [[Synovial]] overgrowth
+|
+[[File:Webp.net-gjhfdifmaker (6).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|-
+![[Osteonecrosis]] ([[Avascular necrosis]])
+|
+* Lack of enhancement and devascularized areas on gadolinium-enhanced MR imaging
+* [[Bone marrow]] [[edema]] on MRI
+* Low-signal-intensity marginal areas on standard spin-echo T1- and T2-weighted images
+* Intermediate to high signal intensity inside bone tissue on T2-weighted images, producing a line of low signal intensity with an adjacent high-signal-intensity line
+* High signal intensity on T2-weighted images due to subchondral fractures that may be accompanied by fluid signal intensity or [[edema]]
+* Low signal intensity on T2-weighted images due to collapse of the [[articular surface]]
-==Key MRI Findings in Systemic Lupus Erythematosus==
+* Early or subtle insufficiency fractures especially on T2-weighted MR imaging
+** In characteristic stress locations insufficiency fractures may appear as areas of high signal intensity due to [[bone marrow]] edema
+|
+[[File:Webp.net-gifmjyfssaker (7).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
-==Examples of MRI Findings in Systemic Lupus Erythematosus==
+[[File:Webp.net-gifmakk2er (8).gif|thumb|300px|<SMALL><SMALL>''[https://radiopaedia.org/ Adapted from Radiopaedia]''</SMALL></SMALL>]]
+|}
 ==References==

Systemic lupus erythematosus MRI: Difference between revisions

Latest revision as of 16:21, 1 February 2018

Overview

Key MRI findings in systemic lupus erythematosus

References

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