Asymptomatic cerebrovascular lesions detected by magnetic resonance imaging in patients with systemic lupus erythematosus lacking a history of neuropsychiatric events

Intern Med. 1999 Oct;38(10):785-95. doi: 10.2169/internalmedicine.38.785.


Objective: To clarify the extent of asymptomatic cerebrovascular involvement in systemic lupus erythematosus (SLE).

Patients and methods: Cerebral magnetic resonance imaging (MRI) findings and ultrasonography findings of 100 patients with SLE lacking present or past clinical neurologic deficits were compared with 66 age-matched volunteers to determine the combined intima-media thickness (IMT) of the common carotid artery, and tests for anti-cardiolipin antibodies (aCL).

Results: Thirty-eight patients, but only 2 controls, showed imaging abnormalities. Among 23 SLE patients with cerebrovascular lesions by MRI who underwent single-photon emission computed tomography (SPECT), 14 showed hypoperfusion of the lesion. The IMT value and prevalence of aCL did not differ between the 55 SLE patients tested and controls. SLE disease activity index (SLEDAI) as assessed by a quantitative clinical index was significantly greater in patients with brain lesions than in those without.

Conclusion: The prevalence of asymptomatic brain lesions in SLE patients is highs and shows a relationship to disease activity.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / adverse effects
  • Adult
  • Aged
  • Antibodies, Anticardiolipin / blood
  • Brain / diagnostic imaging
  • Brain / pathology
  • Carotid Artery, Common / diagnostic imaging
  • Case-Control Studies
  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / etiology*
  • Electrocardiography
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / classification
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / diagnostic imaging
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Severity of Illness Index
  • Tomography, Emission-Computed, Single-Photon
  • Ultrasonography


  • Adrenal Cortex Hormones
  • Antibodies, Anticardiolipin