子痫前期及子痫所致可逆性后部白质脑病综合征影像表现与临床分析

Radiographic and clinical analysis on the patients with preeclampsia and eclampsia combined with reversible posterior leukoencephalopathy syndrome

目的：探讨子痫前期及子痫所致可逆性后部白质脑病综合征（reversible posterior leukoenphalopathy syn-drome ，RPLS ）影像学表现与临床特点。方法回顾性分析我院2009年8月～2011年12月8例子痫前期及子痫患者致可逆性后部白质脑病综合征影像表现与临床资料。结果 RPLS影像学病灶分布，顶枕叶8例，颞叶4例，额叶6例，丘脑1例，基底节1例，CT表现两侧顶枕叶区斑片状的低密度区，灰白质界限模糊，脑回样对称分布，可伴有额叶、颞叶部位脑白质低密度影，灰质一般不受累，MRI表现为T1WI等或低信号，T2WI高信号，FLAIR序列呈高信号，DWI呈等或高信号，ADC呈高信号影，临床表现癫痫发作5例，头痛4例，意识障碍5例，视物模糊1例，高血压8例，所有患者经治疗症状消失，无后遗症。结论认识RPLS特有的影像表现，结合子痫前期及子痫临床特点能得出正确诊断。

Objective To investigate the imaging findings and clinical features of the patients with preeclampsia and ec-lampsia combined with reversible posterior leukoencephalopathy syndrome （ RPLS） .Methods The radiographic and clin-ical data of patients with preeclampsia and eclampsia combined with RPLS ,who were treated in our hospital from August 2009 to December 2011 ,were analyzed retrospectively .Results Eight patients were found with parieto-occipital lobe le-sions ,four patients were found with temporal lobe lesions ,six patients were found with frontal lobe lesions ,one patient was found with basal ganglia lesions and one patient was found with thalamus lesion .The imaging characteristics of RPLS on CT were multiple low density in white matter of parietal lobe and occipital lobes ,which were the most commonly affect-ed areas ,followed by frontal lobes and temporal lobes .Images showed that lesions were blurring of gray matter and white matter junction ,gyrus like and most lesions were distributed symmetrically .The lesions on MRI appeared as hypointensity or isointensity on T1 and hyperintense on T2 ,hyperintense on FLAIR ,hyperintensity or isointensity on DWI and hyperin-tense on apparent diffusion coefficient （ADC） maps .The main clinical symptoms were seizure disorder （5 cases） ,head-ache （4 cases） ,consciousness disorders （5 cases） ,visual disturbance （1 case） ,and hypertension （8 cases） .The clinical symptoms were totally shown favorable prognosis after treatments .Conclusion Combining the characteristics of clinical manifestations with radiographic changes of RPLS is helpful to diagnosis .