PMC8713754_01
Cerebral magnetic resonance imaging on day 4. Axial FLAIR scan showed high signals in the left frontal lobe (A) and lentiform nucleus (B).
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F1
T2-white matte hyperintensities in her left frontal lobe and left lentiform nucleus (Figure 1). The presence of clinical and laboratory criteria led to the diagnosis of SLE and SLE-associated MAS.
Cerebral magnetic resonance imaging on day 9. Axial FLAIR scan showed high signals in the bilateral cerebellum (A); the bilateral basal ganglias and left frontal, temporal, insular, and parietal lobes (B); and the right corpus callosum and left parietal lobe (C).
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F2
On day 9 the second cerebral MRI showed rapid progress (Figure 2), with multi-focal abnormal signals mainly involving white matter (bilateral temporal, cerebellum, insular lobes, and basal ganglias; left frontal and parietal lobes; right corpus callosum).
Cerebral magnetic resonance imaging on day 13. Axial T2-weighted scan showed an increase in white matter swelling (A,B). Apparent diffusion coefficient maps demonstrated infarcts in the left lentiform nucleus and the frontal, temporal, insular, and parietal lobes (C). Axial T1-weighted scan showed small areas of hemorrhages in the frontal and insular lobes (D).
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F3
On day 13 the third MRI demonstrated small infarcts in the left lentiform nucleus, left frontal lobe, temporal lobe, insular lobe, parietal lobe, and right corpus callosum, revealed by decrease in apparent diffusion coefficient in the gray matter, and an increased swelling in the surrounding white matter (Figure 3).
Cerebral magnetic resonance imaging on day 25. Axial T2-weighed scan (A) and apparent diffusion coefficient (ADC) maps (B) showed a decrease in white matter swelling.
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F4
On day 25 she had a fourth MRI scan and achieved neuroimaging improvements (Figure 4).