Neuropsychiatric (NP) syndromes are an important cause of morbi-mortality in patients
with Systemic Lupus Erythematosus (SLE). Despite remarkable recent progress, there are no definite
methods to diagnose neuropsychiatric SLE (NPSLE) or to differentiate primary NPSLE from
secondary causes. NPSLE remains a diagnosis of exclusion, and the clinical judgment is still the
main approach to the correct diagnosis. Within this complex context, the Magnetic Resonance Imaging
(MRI) has both a diagnostic role, by showing the nervous system involvement on one hand
and excluding other causes on the other hand, and a prognostic role, help in assessing the lesions
and monitoring the evolution. Conventional MRI shows brain involvement in around half of the patients,
although the described findings are rather non-specific and present in many other diseases.
However, many advanced MRI techniques are becoming increasingly used over the last period,
showing abnormalities even in normal-appearing brains on conventional MRI. These MRI techniques
hold promise to have a higher sensitivity and specificity than conventional MRI for NPSLE
related changes. This review explores the place and the future perspectives of different advanced
MRI techniques in NPSLE.