摘要
目的探讨可逆性后部白质脑病综合征(reversible posterior leukoencephalopathy syndrome,RPLES)的临床和影像学特点。方法回顾性分析中国人民解放军第306医院4例RPLES的临床症状及影像学特点。结果本组病例病因包括肾功能不全,高血压病,妊娠子痫,腰椎手术后。所有病例均有癫痫大发作及头痛,恶心呕吐,精神行为异常。其中肢体瘫痪1例,失语1例,癫痫持续状态1例。影像学表现为单侧或双侧以顶枕叶为主白质及灰质病变,病变范围可累及额颞叶。磁共振成像(magnetic resonance imaging,MRI)表观弥散系数(apparent diffusion coefficient,ADC)、T_2加权像、平扫液体衰减反转恢复序列(fluid attenuated inversion recovery,FLAIR)均呈高信号,T_1加权像呈略长信号,1例磁敏感成像上呈微出血。结论头痛和癫痫发作是RPLES的主要临床症状,多种病因可引起RPLES,影像学改变以皮质及皮质下水肿为主。
Objective To investigate the clinical and imaging characteristics of reversible posterior leukoencephalopathy syndrome（RPLES）.Methods The clinical manifestation and imaging finding of 4 patients were analyzed retrospectively.Results The cause of those enrolled subjects included renal failure,hypertension,eclampsia gravidarum and post-operation of lumbar surgery. All 4 cases had the clinical manifestations of headache and epilepsy,nausea and vomiting and mental behavior disorder. Among which,there were 1 case of acroparalysis,1 case of aphasia and 1 case of persistent state of epilepsy. magnetic resonance imaging（MRI） showed bilateral or unilateral leukoencephalopathy and grey matter lesion in parieto-occipital subcortical lobes,and the lesion area might involve frontal-temple lobe. The MRI apparent diffusion coefficient（ADC）,T2 weighted image,scan fluid attenuated inversion recovery（FLAIR） sequence were all presenting hyperintense and T1 weighted image were presenting slightly hyperintense. MRI susceptibility weighted imaging showed micro-bleeding in 1 case.Conclusion RPLES is associated with miscellaneous causes. Epilepsy and headache are the principal clinical symptoms in RPLES. Imageological changes are mainly cortical and subcortical edema.
出处
《中国卒中杂志》
2016年第3期179-183,共5页
Chinese Journal of Stroke
关键词
可逆性后部白质脑病综合征
磁共振成像
癫痫
Reversible posterior leukoencephalopathy syndrome
Magnetic resonance imaging
Epilepsy
