可逆性后部脑病综合征影像学分布模式的初步探讨  

Imaging Distribution Patterns of Posterior Reversible Encephalopathy Syndrome(PRES):A Preliminary Study

作　　者：高波[1] 岳凤斌[1] 高伟[1] 刘奉立[1] 沈桂权[2] 王学建[2] 

机构地区：[1]烟台毓璜顶医院影像科,264000 [2]贵阳医学院附属医院放射科

出　　处：《临床放射学杂志》2009年第3期306-309,共4页Journal of Clinical Radiology

摘　　要：目的探讨可逆性后部脑病综合征(PRES)的影像学病灶分布模式。资料与方法回顾性分析32例PRES患者的临床和影像学资料,32例均行MRI检查和复查,包括常规T1WI、T2WI、FLAIR序列,其中21例行扩散加权成像(DWI)检查。对病灶部位分布的关系采用四格表χ2检验,以P<0.05作为差异有统计学意义。结果在病灶累及部位上,顶枕叶与其他各部位如深部白质、脑干、基底节区及胼胝体相比差异均有统计学意义(P<0.05);在病灶分布模式上,除16例(50%)以顶枕叶分布为主的经典型以外,还有3种变异影像学分布模式:全脑型(8例)、不对称型(5例)和脑干型(3例)。结论双侧大脑半球后部尤其是顶枕叶白质内血管源性脑水肿是PRES最特征性影像学表现,准确识别其不典型影像学表现对PRES的正确诊断具有重要意义。Objective To investigate the imaging distribution patterns of posterior reversible encephalopathy syndrome （PRES）. Materials and Methods The clinical and radiologic data were retrospectively analyzed in thirty-two patients. Conventional T1 ,T2-weighted imaging and FLAIR sequences were performed in all patients at first scan as well as follow- up. Diffusion-weighted imaging examinations were performed in twenty-one patients. Results The lesions located in cortex and subccortical white matter had more reversibility than those of in deep structures, such as deep white matter, brain stem, basal ganglia regions and corpus callosum（ P 〈 0.05 ）. In addition to 16 cases with classic parietal-occipital lobe dis- tribution pattern, three atypical distribution patterns, such as diffuse type （8 cases）, asymmetric type （5 cases） and brain stem type （3 eases） were also identified. Conclusion Vasogenous brain edema in bilateral posterior cerebral hemispheres especially parietal-occipital lobes is the characteristic feature of PRES. Identifying the atypical distribution pattern would contribute to making a correct diagnosis of PRES.

关 键 词：脑疾病 脑水肿 高血压 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]