可逆性后部白质脑病综合征的磁共振诊断  

MRI Diagnosis of Reversible Posterior Leukoencephalopathy Syndrome

作　　者：许淑惠[1] 陈向荣[1] 汪林[1] 

机构地区：[1]福建医科大学附属泉州市第一医院影像科,362000

出　　处：《中国医药指南》2010年第33期212-214,共3页Guide of China Medicine

摘　　要：目的探讨可逆性后部白质脑病综合征(RPLS)的MRI表现及其诊断价值。方法对福建医科大学附属泉州市第一医院10例经临床证实RPLS病例的MRI表现进行回顾性分析,其中女性8例,男性2例,10例常规行T1WI、T2WI、FLAIR序列成像,弥散加权成像(DWI),6例行MR静脉成像(MRV)。结果 10例患者MRI检查均发现脑白质水肿,7例为双侧对称性分布,3例不完全对称;病变累及顶枕叶居多,少数累及基底节区、颞叶、额叶。病灶在T1WI为等、低信号,T2WI呈高信号,FLAIR呈明显高信号,DWI呈低信号或等信号,MRV脑静脉、静脉窦未发现异常。10例治疗好转后复查,5例病灶完全消失,3例大部分消失,2例部份消失。结论 MRI在可逆性后部白质脑病综合征的诊断和鉴别诊断中有重要的价值,尤其以FLAIR序列最为敏感;MRI是首选检查。Objective To study the MRI imaging feature of Reversible posterior leukoencephalopathy syndrome （RPLS） and explore the value of MRI on the diagnosis of RPLS. Methods MRI findings in 10 patients with clinically proved RPLS in Fujian Mecical University Affiliated First Quanzhou Hospital were analyzed retrospectively, 8 female and 2 male. All of 10patients had MRI imaging routinely（T1WI, T2WI, FLAIR, DWI）, 3 had MRV. Results MRI examination showed edema of white matter in all 10 cases. The lesions were bilaterally symmetrical in 7 cases, and were dissymmetrical in other 3 cases. The lesions mostly located in bilateral parieto-occipital lobes, and few located in basal ganglia area, temporal lobe, frontal lobes. The lesions appear as hypointense or isointense on T1-weighted images, hyper-intense on T2-weighted images, very hyper-intense on FLAIR, and hypointense or isointense on DWI. MRV showed the cranial veins and sinuses were normal. Follow up scan was performed in 10 cases, and the lesions disappeared completely in 5 cases, most lesions disappeared in 3case, part lesions disappeared in 2 case. Conclusion MRI plays an important role on the diagnosis and differential diagnosis of RPLS, and FLAIR is most sensitive. So that MRI is the first choice in accessory examination.

关 键 词：逆性后部白质脑病综合征 磁共振成像 弥散加权成像 

分 类 号：R742[医药卫生—神经病学与精神病学]