磁共振成像对孕产妇急性脑病的诊断价值  

The diagnostic value of MRI in maternal acute encephalopathy

作　　者：常利名 杨新宇[1] 石丽莉[2] 么秀明 关红菲 舒炜[2] 李光民[2] CHANG Liming;YANG Xinyu;SHI Lili;YAO Xiuming;GUAN Hongfei;SHU Wei;LI Guangmin(Department of Radiology,Tangshan Gongren Hospital,Tangshan 063000,China;Department of Radiology,Tangshan Maternal and Child Health Hospital,Tangshan 063000,China;Department of Radilogy,Tangshan Paraplegia Sanatorium,Tangshan 063000,China)

机构地区：[1]唐山市工人医院放射科,河北唐山063000 [2]唐山市妇幼保健院放射科,河北唐山063000 [3]唐山市截瘫疗养院放射科,河北唐山063000

出　　处：《实用放射学杂志》2020年第7期1019-1022,共4页Journal of Practical Radiology

基　　金：河北省医学重点科技研究计划项目(20191546)。

摘　　要：目的 探讨MRI在妊娠相关急性脑组织病变中的诊断价值.方法 回顾性分析可逆性后部脑病综合征(RPES)、韦尼克脑病(WE)、静脉窦血栓(IVST)患者的临床资料,总结孕产妇较常见急性脑组织病变的病理、临床特点及对应的MRI影像特点.结果 RPES患者28例,WE患者13例,IVST患者3例,3类患者均表现为不同程度的头痛、呕吐、癫痫及意识障碍;RPES影像特点主要为双侧大脑半球皮层及皮层下白质(尤以顶枕叶好发)对称性病变;WE主要表现为双侧丘脑内侧、第三脑室及中脑导水管周围、乳头体区对称性病变;IVST影像特点常见为后枕部静脉流空消失伴相应区域脑组织肿胀,可伴脑回表面少量出血.结论 MRI对妊娠合并RPES、WE及IVST可以辅助进行临床诊断.Objective To explore the diagnostic value of MRI in pregnancy-related acute brain tissue lesions.Methods Analyzed patients with reversible posterior encephalopathy syndrome(RPES),Wernicke encephalopathy(WE)and intracranial venous sinus throm bosis(IVST)retrospectively,and summarized the pathological and clinical features,corresponding MRI features of pregnant and postpartum women with acute encephalopathy.Results There were 28 RPES patients,13 WE patients and 3 IVST patients,all the three types of patients presented with headache,vom iting,epilepsy and disturbance of consciousness in different degrees.The imaging features of RPES were mainly symmetrical lesions in bilateral cerebral cortex and subcortical white matter(especially parietal and occipital lobe);the main manifestations of WE were symmetrical lesions in bilateral medial thalamus,third ventricle,periaqueductal area and papillary body area;and the common imaging features of IV ST were the disappearance of venous em ptying in posterior occipital region,brain tissue swelling in the corresponding region,and minor hemorrhage on the surface of gyrus.Conclusion MRI can provide auxiliary diagnosis for pregnancy complicated with RPES,WPZ and IVST.

关 键 词：妊娠 可逆性后部脑病综合征 韦尼克脑病 静脉窦血栓 磁共振成像 

分 类 号：R714.1[医药卫生—妇产科学] R742[医药卫生—临床医学]