Wartość tomografii komputerowej i rezonansu magnetycznego w diagnostyce zmian w centralnym układzie nerwowym u pacjentów z twardziną układową

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Background: Systemic sclerosis is an autoimmune connective tissue disease characterized by vascular abnormalities and fibrotic changes in skin and internal organs. The aim of the study was to investigate involvement of the central nervous system in systemic sclerosis and the value of computed tomography (CT) and magnetic resonance imaging (MRI) in evaluation of central nervous system involvement in systemic sclerosis. Material/Methods: 26 patients with neuropsychiatric symptoms in the course of systemic sclerosis were investigated for central nervous system abnormalities by computed tomography (CT) and magnetic resonance imaging (MRI). Results: Among these 26 symptomatic patients lesions in brain MRI and CT examinations were present in 54% and in 50% patients respectively. Most common findings (in 46% of all patients), were symptoms of cortical and subcortical atrophy, seen in both, MRI and CT. Single and multiple focal lesions, predominantly in the white matter, were detected by MRI significantly more frequently as compared to CT (62% and 15% patients respectively). Presence of brain atrophy and focal lesions in CT and MR correlated with disease duration (both p<0,0001), extent of skin involvement (p<0,01) and presence of pulmonary fibrosis in the course of the systemic sclerosis (p=0.001). Conclusions: These data indicate that brain involvement is common in patients with severe systemic sclerosis. MRI shows significantly higher th an CT sensitivity in detection focal brain lesions in these patients.