摘要
目的:总结可逆性后部脑病综合征(PRES)的临床及影像学表现特点,以提高对该病的认识。方法:回顾性分析13例确诊为PRES患者的临床表现和影像学检查资料。结果:患者既往病史包括系统性红斑狼疮、原发性高血压、急性淋巴细胞白血病、子痫、血小板减少性紫癜、宫颈癌术后,1例患者无特殊病史。12例为急性起病,临床常见症状包括发作性癫痫、意识障碍、视觉障碍、头痛、恶心等,发作时均有血压升高;1例为亚急性起病。影像学表现病灶主要分布于双侧大脑半球后部皮层下白质区,常可累及皮层,颞叶、额叶、小脑、脑干等部位也可同时受累。CT表现为低密度影,MRI呈等或稍长T1、长T2信号,Flair序列高信号,10例患者DWI呈高或略高信号,3例DWI未见异常,ADC图均为高信号;8例行MR增强扫描,其中6例无强化,2例出现不同程度增强;4例行MRA检查未发现明显血管异常。经治疗后患者临床及影像学异常表现大多完全恢复。结论:MRI是PRES的最佳检查及随访手段,Flair和DWI是PRES检查中两个重要序列;PRES临床和影像学表现具有一定特点,认识这些特点对于正确诊断和治疗具有重要意义。
Objective：To summarize the clinical and imaging characteristics of PRES and to improve the recognition of this disease.Methods：13 cases of confirmed PRES were analyzed retrospectively,including their clinical manifestations and imaging results.Results：The medical history of the 13 patients included systematic lupus erythematosus,primary hypertension,acute lymphocytic leukemia,eclampsia,idiopathic thrombocytopenic purpura,and postsurgery of cervical cancer.The main clinical symptoms included seizures,conscious disturbance,visual abnormalities,headaches,and vomiting.Neuroimaging showed bilateral symmetrical abnormalities in the posterior subcortical white matter regions of the brain.Lesions displayed low density on CT and hypo-isointensity on T1WI,hyperintensity on T2WI and FLAIR.10 cases were found high signal but 3 cases found no abnormalties on DWI,all lesions were hyperintensity on ADC map.6 cases showed no enhancement and 2 cases were enhanced after contrast administration of 8 patients.There were no obviously abnormal vessels in 4 cases that underwent cranial MRA.Clinical symptoms and neuroimaging changes can be recovered completely after effective treatment.Conclusion：MRI has great value and Flair,DWI are two important methods in diagnosis and follow up in PRES patients.There are some clinical and MRI characters in patients with PRES.Combined clinical information with neuroimaging,the correct diagnosis and treatment can be made.
出处
《医学影像学杂志》
2011年第4期503-506,共4页
Journal of Medical Imaging
