大脑后部可逆性脑病综合征CT及MRI表现

Posterior Reversible Encephalopathy Syndrome:Diagnosis with CT and MR

目的:探讨大脑后部可逆性脑病综合征(PRES)的CT、MRI表现特点及鉴别诊断。材料与方法:6例患者纳入研究,女性5例,男性1例。4例行CT平扫,6例行常规MR扫描,2例行MRA。结果:4例患者病灶位于两侧顶、枕叶,另2例病灶广泛分布于两侧额、顶、枕、颞叶。病变以累及皮层及皮层下白质为主,CT上呈较对称的片状低密度灶,在常规磁共振上,T2WI及FLAIR呈高信号,T1WI呈略低信号。MRA显示双侧大脑前动脉、大脑中动脉及大脑后动脉终末支未见明显狭窄。结论:FRES为血管源性水肿,好发于大脑后部的两侧顶枕叶局部皮层及皮层下白质,呈较对称分布,CT及MRI表现较具有特征性。

Purpose： To evaluate the role of CT and MR[ in the diagnosis of posterior reversible encephalopathy syn- drome（PRES）. Materials and Methods： Six patients with PRES（5 women and 1 man）were enrolled in study. All of them were received routine MR scanning, and two were received MR angiography. CT scanning was performed in 4 patients. Re- suits ： Lesions were found in bilateral parieto - occipital lobes in 4 patients, and fronto - temporo - parieto - occipital lobes in 2 patients. Cortex or subconical while matte were mainly involved and appeared hypoattenuation in CT. Lesions appeared as hyperintense signals on FLAIR and T2 -weighted images, isointense or mildly hypointense signals on T1 -weighted images. Brain arteries were found normally in MRA. Conclusion： Vasogenic edema were appeared in FRES and mainly located in cortex or subconical while matte of bilateral parietooccipital lobes. It＇s characteristic distribution in CT and MRI may be helped in diagnosis.