神经精神系统性红斑狼疮的灌注加权磁共振成像模式:系统回顾和荟萃分析。

IF 2.4 3区 医学 Q2 CLINICAL NEUROLOGY Neuroradiology Pub Date : 2024-09-04 DOI:10.1007/s00234-024-03457-1
Narges Azizi, Mahbod Issaiy, Amir Hossein Jalali, Shahriar Kolahi, Hamed Naghibi, Diana Zarei, Kavous Firouznia
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引用次数: 0

摘要

背景:神经精神系统性红斑狼疮(NPSLE)是系统性红斑狼疮(SLE)的一种复杂表现,以各种神经和精神症状为特征。本研究旨在阐明非系统性红斑狼疮患者与无神经精神表现的系统性红斑狼疮患者(非非系统性红斑狼疮)和健康对照组(HCs)相比,其灌注加权磁共振成像(PWI)的模式:在PubMed/Medline、Embase、Web of Science和Scopus上对2024年4月14日之前发表的利用PWI对非淋巴系统性红斑狼疮患者进行的研究进行了系统检索。采用标准化均值差(SMD)作为估计指标,提取非非淋菌性脑病、非非淋菌性脑病患者和高危人群的脑血流(CBF)数据进行荟萃分析。对于缺乏足够数据纳入的研究,我们对CBF、脑血容量(CBV)和平均转运时间(MTT)进行了定性审查:我们的综述包括八项采用脉搏波速度成像技术的观察性研究,包括动态感性对比(DSC)和动脉自旋标记(ASL)。对非淋巴系统性红斑狼疮与非淋巴系统性红斑狼疮进行的荟萃分析包括四项研究,涉及104名非淋巴系统性红斑狼疮患者和90名非非淋巴系统性红斑狼疮患者。结果显示,与非 NPSLE 相比,NPSLE 患者 CBF 的 SMD 为-1.42(95% CI:-2.85-0.00,I2:94%):脉搏波速度成像揭示了脑灌注的信息模式,显示与非NPSLE患者相比,NPSLE患者的平均CBF显著下降。我们的定性综述强调了这些变化,尤其是额叶和颞叶的变化。然而,现有数据显示出相当大的异质性和局限性。
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Perfusion-weighted MRI patterns in neuropsychiatric systemic lupus erythematosus: a systematic review and meta-analysis.

Background: Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) is a complex manifestation of Systemic Lupus Erythematosus (SLE) characterized by a wide range of neurological and psychiatric symptoms. This study aims to elucidate the patterns of Perfusion-Weighted MRI (PWI) in NPSLE patients compared to SLE patients without neuropsychiatric manifestations (non-NPSLE) and healthy controls (HCs).

Material and methods: A systematic search was conducted in PubMed/Medline, Embase, Web of Science, and Scopus for studies utilizing PWI in NPSLE patients published through April 14, 2024. Cerebral blood flow (CBF) data from NPSLE, non-NPSLE patients, and HCs were extracted for meta-analysis, using standardized mean difference (SMD) as an estimate measure. For studies lacking sufficient data for inclusion, CBF, cerebral blood volume (CBV), and mean transit time (MTT) were reviewed qualitatively.

Results: Our review included eight observational studies employing PWI techniques, including dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL). The meta-analysis of NPSLE compared to non-NPSLE incorporated four studies, encompassing 104 NPSLE patients and 90 non-NPSLE patients. The results revealed an SMD of -1.42 (95% CI: -2.85-0.00, I2: 94%) for CBF in NPSLE compared to non-NPSLE.

Conclusion: PWI reveals informative patterns of cerebral perfusion, showing a significant reduction in mean CBF in NPSLE patients compared to non-NPSLE patients. Our qualitative synthesis highlights these changes, particularly in the frontal and temporal lobes. However, the existing data exhibits considerable heterogeneity and limitations.

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来源期刊
Neuroradiology
Neuroradiology 医学-核医学
CiteScore
5.30
自引率
3.60%
发文量
214
审稿时长
4-8 weeks
期刊介绍: Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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