Systemic lupus erythematosus: prediction by MRI of the subsequent development of brain lesions.

RATIONALE AND OBJECTIVES: Many patients with systemic lupus erythematosus (SLE) manifest the recurrence of new brain lesions on follow-up magnetic resonance imaging (MRI) scans. We assessed whether the initial MRI findings help to predict the subsequent development of brain lesions in patients with SLE. MATERIALS AND METHODS: We enrolled 64 patients with SLE who had undergone initial and follow-up MRI studies. Two radiologists reviewed and categorized the initial MRI findings and divided the patients into those with no lesions on the initial and follow-up MRI scans (group A, n = 18), those with lesions on the initial scans only (group B, n = 32), and those with lesions on the first and new lesions on the follow-up MRI scans (group C, n = 14). We then looked for independent predictors of the subsequent development of brain lesions, such as antiphospholipid syndrome (APS) and findings on the initial MRI studies. RESULTS: The incidence of lacunar and localized cortical infarcts was significantly greater in group C than group B (50% vs. 0%, P < .001 and 50% vs. 9%, P < .05, respectively). Multivariate logistic regression analysis indicated that lacunar or localized cortical infarcts on the initial MRI scans were independent predictors of the subsequent development of brain lesions (odds ratio [OR]: 5.412, 95% confidence interval [CI]: 1.18-24.85, P = .03), whereas the presence of APS was not (OR: 0.621, 95% CI: 0.18-2.19). CONCLUSIONS: The presence of lacunar and/or localized cortical infarcts on initial MRI scans may predict the development of new brain lesions in patients with SLE.