可逆性后部脑病综合征的不典型影像学表现  

Posterior reversible encephalopathy syndrome: atypical yadiologic findingsnd radiologic findings with investigation of its pathogenesis

作　　者：张鸿举 高波[2] 

机构地区：[1]山东省蓬莱市中医医院影像科,山东蓬莱265600 [2]烟台毓璜顶医院影像科,山东烟台264000

出　　处：《医学影像学杂志》2010年第10期1418-1421,共4页Journal of Medical Imaging

摘　　要：目的:研究可逆性后部脑病综合征(PRES)的不典型影像学表现并进一步探讨其可能的发病机制。方法:回顾性分析了57例PRES患者的临床和影像学资料,其中17例行钆喷替酸葡甲胺(Gd-DTPA)增强扫描,35例患者行CT平扫。由2位神经放射医生共同评价不典型影像学异常(脑出血、弥散受限、异常强化),比较脑水肿累及不同部位之间差异。结果:脑水肿顶、枕叶的累及与其他各部位相比均有统计学显著性差异(P<0.05)。弥散受限所致的高信号10例(占17.5%),其中4例发生脑梗死(占7.0%);5例发生颅内出血(占8.8%);17例患者行增强扫描10例出现异常强化(占58.8%)。结论:正确认识PRES不典型表现对PRES的早期诊断具有重要意义,有利于进一步探讨PRES的发病机制及病理生理学改变。Objective：To investigate the atypical neuroimaging findings of posterior reversible encephalopathy syndrome（PRES） and to further discuss its pathogenesis.Methods：The clinical and radiologic data of fifty-seven PRES patients were retrospectively analyzed,in which 17 cases had Gd-DTPA contrast enhancement examinations and 35 cases had cranial CT scannings.Atypical neuroimaging findings including of cerebral hemorrhage,diffusion restricted and abnormal contrast enhancement were independently assessed by two neuroradiologists respectively.The differences were compared between affected brain regions.Results：The incidences of brain edema in parietal,occipital lobes were statistically different from other affected regions（P0.05）.Ten cases had hyperintensity caused by diffusion restricted（17.5%） with four patients cerebral infart occurred（7.0%）,five cases had hemorrhage incured（8.8%） and abnormal contrast enhancement in ten patients（58.8%）.Conclusion：It is vital to be familiar with the atypical radiologic findings of PRES,which would be helpful to further investigate its pathogenesis and pathophysiological changes.

关 键 词：后部白质脑病综合征 脑水肿 高血压 磁共振成像 发病机制 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]