后部白质脑病综合征的DWI表现及与其可逆性的关系

Posterior leukoencephalopathy syndrome:relationship of its DWI findings with reversibility

目的探讨后部白质脑病综合征(PLS)的DWI表现及其可逆性的关系。方法回顾性分析了32例PLS患者的临床和影像学资料,32例均行MRI检查和复查,包括常规T1WI、T2WI、FLAIR及DWI序列;DWI信号表现分为高信号、非高信号组,再根据ADC值是否降低为弥散受限和弥散不受限2类。结果 DWI高信号病灶的可复性与DWI呈等/低信号病灶的可复性经卡方检验比较无统计学差异(P>0.05);结合ADC图,弥散受限组与弥散不受限组之间病灶的可复性有显著统计学差异(P<0.01)。结论 DWI结合ADC图能更可靠地判断PLS的预后。

[Abstract] Objective To investigate diffusion-weighted imaging （DWI） characteristics and its effects on the reversibility of posterior leukoencephalopathy syndrome （PLS）. Methods The clinical and radiologic data were analyzed retrospective ly in thirty-two patients. Conventional MRI and DWI studies were performed in all cases. The relationships between the reversibility and the signal intensity features on DWI, ADC map were appreciated by two neuroradiologists after comparing the initial and follow-up MRI studies. Results The reversibility between the lesions with hyperintensity on DWI and those with iso-intensity or hypo-intensity on DWI had no significant difference （ P 〉0.05）. However, the reversibility between diffusion restricted lesions and unrestricted lesions on ADC maps had markedly significant difference in either hyperintense or iso-, hypointense lesions on DWI, which means that DWI combining with ADC maps would reliably estimate the revers- ibility. Conclusion DWI together with ADC maps would reliably estimate the reversibility.