可逆性后部脑病综合征的MRI表现及诊断  

MRI presentation and diagnosis of posterior reversible encephalopathy syndrome

作　　者：陈卫鹏[1] 林哲聪[1] 林海韬 姚沛旭[1] 徐秋玉[1] 陈曙[1] 

机构地区：[1]揭阳市人民医院放射科,广东揭阳522000

出　　处：《广州医科大学学报》2016年第3期71-74,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨可逆性后部脑病综合征(PRES)的MRI影像学表现,提高对该病的诊断。方法:回顾性分析2012年10月至2015年4月在本院行MRI检查并经临床确诊为PRES的12例患者资料。结果:12例PRES患者头颅MRI表现为双侧后顶颞叶、枕叶对称性的散在小片状T1WI低、T2WI高信号,以白质受累为主,T2WI FLAIR序列显示更清晰,并部分皮层受累及;其中3例病灶累及脑干以及小脑半球,2例累及双侧基底节区。部分DWI高信号灶于ADC图上呈等或稍高信号。随访12例患者,经治疗后复查MRI显示病灶明显减少、消失,患者临床症状基本消失。结论:PRES的MRI表现具有一定特征性。该病发病部位以大脑后循环区域多见,双侧对称性分布,以血管源性水肿为主。MRI检查能够对该病进行早期诊断,帮助临床早期治疗。Objective：To investigate imaging features of posterior reversible encephalopathy syndrome （ PRES） on MRI,and to enhance the diagnosis of this disease. Methods：A retrospective analysis was performed on clinical data from 12 PRES patients who underwent MRI study in our hospital between October 2012 and April 2015. Results：Cranial MRI findings in these 12 PRES patients showed small patches dispersing in a symmetric pattern at bilateral posterior parietotemporal lobes and occipital lobes,which was hypo-echoic by T1WI and hyper-echoic by T2WI. The lesion involved chiefly the white matter, which was more clearly shown by T2WI FLAIR sequence. Part of the cortex was also affected. The lesions involved the brainstem and cerebellum in 3 cases,and bilateral basal ganglia in 2 cases. Some of lesions hyper-echoic by DWI appeared iso- or mild hyper-echoic on ADC maps. During follow-up,MRI of 12 patients revealed that the lesions were remarkably reduced or diminished after treatment,along with resolution of clinical symptoms. Conclusion：MRI findings of PRES appear to be of certain characteristics. The lesions are more frequently located at brain regions with rich cerebral circulation, usually distributed in a bilaterally symmetric pattern,and chiefly associated with vasogenic edema. MRI study may help early diagnosis and prompt for early clinical treatment of posterior reversible encephalopathy syndrome.

关 键 词：可逆性后部脑病综合征 磁共振成像 弥散加权成像 高血压 

分 类 号：R445.2[医药卫生—影像医学与核医学]