Objectives Thrombosis occurring in the central nervous system is common in APS patients, leading to neuropsychiatric symptoms. We investigated the prevalence of silent brain abnormalities on MRI in primary APS (PAPS) patients and aPL carriers and assessed the association between the vascular risk factors, aPL profile, clinical manifestations and MRI abnormalities. Methods We consecutively included 44 PAPS patients, 24 aPL carriers and 23 healthy controls with comparable age and gender in a single-centre, observational, cross-sectional study. None of the patients had a history of stroke, transient ischaemic attack, migraine, dementia, epilepsy or bipolar disorders. On cerebral MRI, we assessed the imaging features and location of abnormality. Multivariate analysis was performed to identify the risk factors contributing to the MRI abnormalities. Results A total of 38 (55.88%) patients had abnormal MRI findings, while only one healthy control showed some abnormalities. Lacunes were the most frequent MRI abnormality in the aPL-positive group [31/68 (45.59%)], which were followed by white matter hyperintensities [20/68 (29.41%)]. In the study population, age [odds ratio (OR) 1.086, P = 0.016] and LA positivity (OR 5.191, P = 0.002) were independent associated factors with brain MRI abnormalities. When analysed in only the aPL-positive group, age (OR 1.116, P = 0.007), female gender (OR 7.519, P = 0.025) and thrombocytopenia (OR 8.336, P = 0.047) were the significant independent risk factors with abnormal MRI. Conclusions PAPS patients and aPL carriers showed a high prevalence of brain MRI abnormalities, indicating an increased cerebrovascular risk, which emphasized attention to silent cerebral lesions in persistently aPL-positive patients.

中文翻译：

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在抗磷脂抗体持续阳性的非神经精神疾病患者中异常磁共振成像发现的高发生率

目的 中枢神经系统血栓形成在 APS 患者中很常见，导致神经精神症状。我们调查了原发性 APS (PAPS) 患者和 aPL 携带者在 MRI 上无症状脑异常的患病率，并评估了血管危险因素、aPL 谱、临床表现和 MRI 异常之间的关联。方法 我们在一项单中心、观察性、横断面研究中连续纳入了 44 名 PAPS 患者、24 名 aPL 携带者和 23 名年龄和性别相当的健康对照。所有患者均无中风、短暂性脑缺血发作、偏头痛、痴呆、癫痫或双相情感障碍病史。在脑 MRI 上，我们评估了异常的影像学特征和位置。进行多变量分析以确定导致 MRI 异常的危险因素。结果共38例（55.88%）患者出现异常MRI表现，仅1名健康对照者出现部分异常。腔隙是 aPL 阳性组中最常见的 MRI 异常 [31/​​68 (45.59%)]，其次是白质高信号 [20/68 (29.41%)]。在研究人群中，年龄 [优势比 (OR) 1.086, P = 0.016] 和 LA 阳性 (OR 5.191, P = 0.002) 是脑 MRI 异常的独立相关因素。仅在 aPL 阳性组中进行分析时，年龄（OR 1.116，P = 0.007）、女性（OR 7.519，P = 0.025）和血小板减少症（OR 8.336，P = 0.047）是 MRI 异常的显着独立危险因素。结论 PAPS 患者和 aPL 携带者表现出较高的脑 MRI 异常发生率，表明脑血管风险增加，