HELLP综合征的影像学表现  

Imaging findings of HELLP syndrome

作　　者：王杏[1] 宋文艳[1] 张岩岩[1] 李宏军[1] WANG Xing;SONG Wenyan;ZHANG Yanyan;LI Hongjun(Department of Radiology,Beijing You'an Hospital,Capital Medical University,Beijing 1000699,China)

机构地区：[1]首都医科大学附属北京佑安医院放射科,北京100069

出　　处：《实用放射学杂志》2020年第4期603-606,共4页Journal of Practical Radiology

摘　　要：目的探讨HELLP综合征的影像学表现,提高对该疾病的认识.方法回顾性分析10例经临床及实验室证实的HELLP综合征患者的影像及临床资料.结果3例头颅CT示脑白质对称分布的低密度影,以枕顶叶为主.1例头颅MRI显示双侧顶枕叶病变以液体衰减反转恢复(FLAIR)序列和ADC图像上的高信号为特征,而DWI未见显示;另可见左侧侧脑室前角旁及右顶叶异常信号,DWI均未见扩散受限.6例X线片显示双侧肺门周围片状模糊影,其中3例伴有胸腔积液.1例腹部CT示肝右叶包膜下新月形低密度影,动脉期未见明确强化,门脉期及平衡期呈不均匀轻度强化;其腹部MRI显示病变平衡期病灶内网格状强化,邻近肝实质灌注异常.结论HELLP综合征影像学异常多累及神经系统、呼吸系统及消化系统,主要表现为脑白质血管源性水肿、肺水肿及肝脏损害.Objective To investigate the imaging features of IIELLP syndrome and improve the ability of understanding this disease.Methods The imaging and clinical data of 10 HELLP syndrome patients were analyzed retrospectively.Results Brain CT images of 3 patients showed symmetrical low-density in the white matter,mainly in the occipital and parietal lobes.In 1 case,MRI showed the lesions of the occipital and parietal lobes were characterized by hyper-signal intensity in the fluid attenuated inversion recovery(ELAIR)sequence and in the ADC imaging,but these lesions were not shown on DWI.In addition,abnormal signals were also seen around the anterior horn of the left lateral ventricle and in the right parietal lobe,and diffusion limitation was not observed on DWI images for the above lesions.Abnormal chest X-ray plain films were seen in 6 patients,showing blurred shadows around bilateral hila,and 3 patients of them were accompanied by pleural effusion.There was sub-capsular low density shadow in the right lobe of liver on 1 abdominal CT scan,no definite abnormal enhancement was observed in this lesion during the arterial-phase of enhanced scanning,while mild enhancements were shown in the portal and delayed phasc.The abdominal MRI of this lesion showed grid-like enhancement in this lesion in the delayed-phase.Abnormal perfusion was also observed in the hepatic parenchyma adjacent this lesion.Conclusion Imaging abnormalities of HELLP syndrome are always discovered in the nervous system,respiratory system and digestive system.The imaging features mainly are vasogenic edema of the white matter,pulmonary edema and liver damage.

关 键 词：HELLP综合征 计算机体层成像 磁共振成像 

分 类 号：R714.25[医药卫生—妇产科学] R814.42[医药卫生—临床医学]