可逆性胼胝体压部综合症的临床表现及MR诊断  

Clinical appearances and MR imaging diagnosis of reversible splenial lesion syndrom( RESLES)

作　　者：刘明[1] 尹秋凤[1] 夏正荣[1] 李芳珍[1] 张玉珍[1] LIU Ming;YIN Qiufeng;XIA Zhengrong;LI Fangzhen;ZHANG Yuzhen(Deparment of Radiology,Xin Hua Hospital Attached to Medical School of Shanghai Jiaotong Univercity,Shanghai 200092,P.R.China)

机构地区：[1]上海交通大学医学院附属新华医院放射科,上海200092

出　　处：《医学影像学杂志》2018年第3期345-348,共4页Journal of Medical Imaging

摘　　要：目的探讨胼胝体压部综合症的临床表现及MRI影像特点。方法收集18例经临床随访证实的可逆性胼胝体压部综合症患者,回顾性分析临床资料及MRI影像特征。结果 18例患者中,儿童11例,成人7例,病因主要包括感染、惊厥相关和低钠血症。首次MR检查距离发病2~10天不等,影像上,17例患者主要表现为胼胝体压部正中为主孤立性病灶,呈斑片状、圆形或椭圆形,边界清晰或稍模糊,DWI高信号或稍高信号,T_1WI等信号或稍低信号,T_2WI flair为稍高信号,1例幼儿患者,病灶范围自胼胝体压部呈对称性向胼胝体两侧延伸,至侧脑室后角周围。随访后,7例患者复查MRI,病灶异常信号消失或DWI信号明显减低、范围缩小,复查时间距离首次检查天数自6~30天不等,其余11例患者经治疗后临床症状消失,未复查MRI。结论可逆性胼胝体压部综合症的临床症状及病因复杂多变,但是预后良好,MR影像具有特征性,尤其DWI序列突出表现为胼胝体压部为主的可逆性、孤立性高信号病灶,可以明确诊断并指导临床治疗。Objective To investigate the features of clinical appearances and MR imaging in reversible splenial lesion syndrome(RESLES).Methods The clinical and MRI imaging data of 18 cases of RESLES were retrospectively reviewed.Results Eighteen cases included eleven children and seven adults,the common causes were convulsion and infections.On the initial cerebral MRI scanning,seventeen cases showed the isolated abnormal signal in the splenial of corpus callosum.Lesions appeared as isointensity or slightly hypo-intensity on T1WI,hyper-or slightly hyper-intensity on T2WI Flair,DWI showed well-margined lesions with high signal.The lesions were round,oval or patchy,with fuzzy or well-defined boundary.No edema around the lesion and no occupying effect were detected.After treatment,7 of 18 cases were reviewed after 6 to 30 days with MRI,and the abnormal signal in the corpus callosum disappeared or significantly reduced,the others cases did not have MRI examination again after treatment and the clinical symptoms disappeared.Conclusion The clinical manifestations of RESLES are complicated and varied,but the cranial MRI imaging is characterized by the reversible solitary lesion of the splenium with significant hyper-intensity signal on DWI,which can provide a reliable basis and guidance for diagnosis and treatment.

关 键 词：可逆性胼胝体压部综合症 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]