妊娠相关后部可逆性脑病综合征17例的临床及影像学表现分析  

Analysis of clinical and imaging features of 17 pregnant patients complicated with PRES

作　　者：王虹壬 彭剑峰[1] 袁子雄 Wang Hongren;Peng Jianfeng;Yuan Zixiong(Department of Image,the People′s Hospital of Huadu District,Guangzhou,Guangdong 510800,China)

机构地区：[1]广州市花都区人民医院影像科,510800

出　　处：《中国基层医药》2020年第6期685-689,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨妊娠相关后部可逆性脑病综合征(PRES)患者的影像学特点,提高对该病的认识。方法:回顾性分析广州市花都区人民医院2011年7月至2017年7月收治的妊娠相关PRES患者17例的临床及影像学资料。结果:患者均为妊娠期子痫前期或子痫患者(产前子痫前期5例,子痫12例)。其中CT检查8例,主要表现为对称性皮质下白质及皮质不规则低密度改变;MRI检查9例,主要表现为MRI液体衰减翻转恢复序列(FLAIR)对称性皮质下白质及皮质异常高信号,磁共振弥散加权成像及表观弥散系数均未见弥散受限信号。病变主要累及双侧顶枕叶17/17例(100.0%),其次为额叶15/17例(88.9%)以及颞叶5/17例(29.4%),亦有基底节区7/17例(41.2%)受累,偶见于胼胝体3/17例(17.6%)、放射冠2/17例(11.8%)及小脑2/17例(11.8%),经对症治疗,1~2周后所有患者临床症状均明显改善,1~3个月后随访无相关临床症状出现。结论:妊娠相关PRES主要累及大脑后循环供血范围,其对称性皮质下白质及皮质血管源性脑水肿的影像表现具有一定特征性,及时治疗效果良好。Objective To investigate the imaging characteristics of pregnant women complicated with posterior reversible encephalopathy syndrome(PRES),in order to improve the understanding of the disease.Methods The clinical and imaging data of 17 pregnant patients complicated with PRES from July 2011 to July 2017 of the People′s Hospital of Huadu District in Guangzhou were analyzed retrospectively.Results All patients were preeclampsia or eclampsia in pregnancy(5 cases with eclampsia,12 cases with eclampsia).Among them,8 cases underwent CT examination,9 cases underwent MRI examination Typical imaging findings were symmetrical subcortical white matter and subcortical cerebral edema presented as irregular low density area on CT images and symmetric subcortical white matter and abnormal cortical signal on MRI fluid-attenuated inversion recovery(FLAIR)images.Diffuse-limited signals were not observed in both DWI and ADC.The location of lesions were parieto-occipital lobes[100.0%(17/17)],followed by frontallobe[88.9%(15/17)],temporal lobe[29.4%(5/17)],basal ganglia[41.2%(7/17)],corpus callosum[17.6%(3/17)],radiant crown[11.8%(2/17)]and cerebellum[11.8%(2/17)].After symptomatic treatment,the clinical symptoms of all patients were significantly improved after 1-2 weeks,and no clinical symptoms were observed after 1-3 months of follow-up.Conclusion The characteristic imaging features can be assessed in pregnant patients complicated with PRES,which presented as symmetrical subcortical white matter and subcortical cerebral edema,mainly involved the region supplied by posterior circulation,got good results after treatment timely.

关 键 词：脑疾病 后部可逆性脑病综合征 妊娠 血管源性脑水肿 磁共振成像 体层摄影术 X线计算机 鉴别诊断 

分 类 号：R737[医药卫生—肿瘤]