化疗并发可逆性后部脑病综合征磁共振成像特征分析  

MRI features of chemotherapy complicating by posterior reversible encephalopathy syndrome

作　　者：徐新华 张进 Xu Xinhua;Zhang Jin(Department of Radiology,Changzhou Cancer Hospital of Soochow University, Suzhou 213032,China)

机构地区：[1]苏州大学附属常州肿瘤医院影像科,213032

出　　处：《中华诊断学电子杂志》2021年第4期264-267,共4页Chinese Journal of Diagnostics(Electronic Edition)

摘　　要：目的探讨恶性肿瘤患者应用化学治疗并发可逆性后部脑病综合征(PRES)的磁共振成像(MRI)特征。方法回顾性分析2012年2月至2020年12月于苏州大学附属常州肿瘤医院肿瘤内科治疗的7例恶性肿瘤患者经化学药物治疗并发PRES的临床和MRI资料。所有患者化疗前均有头颅MRI资料,未发现脑转移。头颅MRI检查包括T_(2)WI、T_(1)WI、FLAIR、DWI序列,其中3例患者进行增强扫描。结果头颅MRI显示病变呈对称性分布,累及双侧枕叶、顶叶7例,累及双侧额叶3例,双侧小脑半球2例。MRI呈T_(1)WI低信号,T_(2)WI及FLAIR高信号,DWI呈稍高信号。3例增强扫描患者中,1例未见强化;2例出现线状、结节状强化,其中1例1周后双侧枕叶出现大片状显著强化区。所有患者临床治疗1~2周后复查头颅MRI,病灶缩小或消失,2例新见原病变区以外的腔隙性脑梗死。结论临床资料结合MRI,对于正确诊断化学治疗后PRES有重要意义。Objective To explore MRI features of chemotherapy complicating by posterior reversible encephalopathy syndrome(PRES)in patients with malignant tumors.MethodsFrom February 2012 to December 2020,clinical and MRI data of 7 patients with malignant tumors complicated by PRES after chemotherapy who were treated in Oncology Department of Changzhou Cancer Hospital of Soochow University were retrospectively analyzed.All patients had head MRI data before chemotherapy,and no brain metastasis was confirmed.MRI imaging of 7 patients included T_(2)WI,T_(1)WI,FLAIR and DWI sequences,3 of the patients underwent contrast enhancement.ResultsMRI showed bilaterally symmetrical distributions of lesions.Bilateral occipital lobe and parietal lobe were involved in 7 patients,bilateral frontal lobe in 3 cases and bilateral cerebellar hemisphere in 2 cases.The lesions appeared as hypointense on T_(1)WI,hyperintense on T_(2)WI and FLAIR,slightly hyperintense on DWI.In 3 patients with enhanced scanning,1 case was not enhanced obviously,2 cases appeared linear or nodular enhancement,including large patch enhancement in 1 case after a week.The lesions were reduced or disappeared after one to two weeks with treatment in all cases,and lacunar infarction of new area was found in 2 patients.ConclusionClinical data combined with MRI is of great significance for the correct diagnosis of chemotherapy complicating by PRES in patients with malignant tumors.

关 键 词：化学治疗 磁共振成像 可逆性后部脑病综合征 

分 类 号：R73[医药卫生—肿瘤]