Background Systemic sclerosis (SSc) is a rare chronic multi-system autoimmune disease of unknown cause and a complex pathogenesis. The hallmark of the disease is microvscular vasculopathy which results in tissue ischemia with recurrent episodes of reperfusion. Diffusion-weighted (DW) Magnetic Resonance imaging (MRI) is an excellent tool for the detection of activity of any vascular or inflammatory lesions.
Objectives Detect brain changes in systemic sclerosis patients with asymptomatic CNS manifestations using fluid attenuation inversion recovery (FLAIR) weighted sequence and diffusion-weighted (DW) sequence MRI.
Methods Fourteen systemic sclerosis female patients (diagnosed according to the 2013 revised ACR/EULAR classification criteria for systemic sclerosis) aged 28-57 years old with disease duration of 1-20 years with no CNS clinical manifestations were included. A controlled group of 14 clinically normal persons, age and sex matched. Both groups were subjected to brain MR examination at 1.5 T; a FLAIR weighted sequence and a DW sequence. Statistical Package for the Social Sciences (SPSS, version 21) was used for statistical analysis.
Results 25 white matter hyperintense lesions ≥5mm in diameter and 12 lesions <5 mm were detected in patient group using FLAIR weighted MRI while diffusion weighted MRI failed to detect the same lesions. A significant correlation (p=0.018) between the presence of white matter hyperintense lesions and the severity of peripheral vascular affection of the disease was observed.
Conclusions Asymptomatic central nervous system vasculopathy is detected in systemic sclerosis using FLAIR MRI, while diffusion MRI failed to detect such lesions. These findings may suggest a non-inflammatory form of central nervous system microvasculopathy in SSc patients.
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Disclosure of Interest None declared