可逆性后部脑病综合征的MRI表现  

MRI Manifestations of Posterior Reversible Encephalopathy Syndrome and Literature Review

作　　者：李婵婵 刘含秋 郝霄竹 田家齐 孙华平 杨艳梅 姚振威 LI Chan-chan;LIU Han-qiu;HAO Xiao-zhu;TIAN Jia-qi;SUN Hua-ping;YANG Yan-mei;YAO Zheng-wei(Department of Radiology, Huashan Hospital, Fudan University,12 Wulumuqi Rd. Middle, Shanghai 200040, P.R.C.)

机构地区：[1]复旦大学附属华山医院放射科

出　　处：《中国医学计算机成像杂志》2018年第3期185-189,共5页Chinese Computed Medical Imaging

基　　金：国家重点研发计划子课题;No.2017YFC0112904~~

摘　　要：目的:探讨可逆性后部脑病综合征(PRES)的MRI表现,以提高早期诊断率。方法:回顾性分析经临床和影像学检查确诊的6例PRES的临床和影像学资料。结果:6例PRES,在病灶部位和形态上,4例额颞顶枕叶、基底节区、脑干、小脑多发病灶呈片状分布且双侧大致对称,2例脑干单发病灶呈斑片状分布;在信号特点上,6例均T2WI高信号、FLAIR高信号、DWI等信号、ADC图高信号;在T1WI上,5例等信号,1例低信号。治疗3周后复查MRI,4例病灶完全吸收,2例病灶大部分吸收。结论:典型PRES的MRI表现包括脑内出现多发对称、后部分布为主的病灶,特别是脑干受累可能对不典型PRES的诊断有重要的提示意义。Purpose： To investigate the MRI features of posterior reversible encephalopathy syndrome to improve the early diagnostic accuracy of this disease. Methods： The clinical and imaging date of 6 cases with posterior reversible encephalopathy syndrome proved by clinic and radiology results were analyzed retrospectively. Results： Four cases were with multiple lesions mainly located in the white matter of frontal temporal parietal occipital lobe, basal ganglia, brainstem and cerebellum, which were shown as nearly symmetrically flake. Two cases were with single brainstem lesion that was shown as patchy abnormal signal. Six cases were with high intensity signal on T2WI, high intensity signal on FLAIR, moderate intensity signal on DWI, high intensity signal on ADC map. On T1WI, 5 cases were with moderate intensity signal and 1 case was with low intensity signal. Two weeks after treatment, all the lesions were disappeared completely in 4 cases, but the lesions in other 2 cases were disappeared incompletely. Conclusion： Typical MRI manifestations of posterior reversible encephalopathy syndrome were multiple symmetrical lesions mainly located in posterior part of the brain. Brainstem lesion may have important significance for the diagnosis of atypical posterior reversible encephalopathy syndrome.

关 键 词：可逆性后部脑病综合征 磁共振成像 高血压 

分 类 号：R445.2[医药卫生—影像医学与核医学]