SLE-Sjögren overlap syndrome

Imaging of

intestinal vasculitis focusing on MR and CT enterography: a two-way street between radiologic findings and clinical data. Intestinal ischemia in a 31-year-old female with known SLE-Sjögren overlap syndrome presenting with fever, anemia, and LUQ pain. MRE was obtained. Coronal T2-W and post-contrast T1-W images (A, B) display mural thickening, mucosal hypoenhancement, and serosal hyperenhancement of descending colon adjacent to the splenic flexure (thick white arrows) suggestive for mucosal ischemic changes. Coronal T2-W and post-contrast T1-W images (C, D) display mural thickening and increased mural enhancement of the cecum and ascending colon (Thin white arrows). Axial T2-W image and corresponding DWI sequence (E, F) show concentric mural thickening of the proximal ascending colon, demonstrating restricted diffusion (white arrowheads), in favor of ischemic changes or increased inflammatory cells. Coronal post-contrast T1-W image (G) reveals subcapsular areas of splenic hypoenhancement (white dotted oval), indicative of infarction. Pale and fragile mucosa is seen in colonoscopic view (H) of the involved colonic splenic flexure