Evaluation Of Brain Changes In Systemic Sclerosis (Ssc) Patients Using Two Different Techniques Of Mri: Is It Really Worthy?

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 microvascular 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: Fifteen systemic sclerosis female patients aged 27-60 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. SPSS (version 20) was used for statistical analysis. Results: 37 white matter hyperintense lesions (<= 2 to >= 5 mm in diameter) were detected in patient group using FLAIR weighted MRI while diffusion-weighted MRI failed to detect the same lesions. A nonsignificant relation (P = .259) 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 suggest a non-inflammatory form of central nervous system microvasculopathy in SSc patients. (C) 2019 Elsevier Espana, S.L.U. and Sociedad Espanola de Reumatologia y Colegio Mexicano de Reumatologia. All rights reserved.