34 yo F with SLE with chronic depression; evaluate for any underlying white matter changes/lupus cerebritis The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.There is a subcortical white matter lesion in the left centrum semiovale which is bright on T2 and FLAIR MRI. In isolation this is nonspecific.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a mucous retention cyst in the left maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
There is no evidence for cerebral infarction or any convincing evidence for effects of encephalitis on this exam.