可逆性后部脑病综合征的CT及MRI诊断

The CT and MRI Imaging Diagnosis of Posterior Reversible Encephalopathy Syndrome

目的分析可逆性后部脑病综合征的CT及MR影像学表现,提高对该病的诊断。方法回顾性分析15例可逆性后部脑病综合征患者临床资料及影像学资料,其中女性10例,男性5例,9例患者行CT平扫,8例患者行MR扫描,其中2例患者同时行CT及MR扫描。结果可逆性后部脑病综合征表现为以枕顶叶白质区为主的异常改变,CT图像呈片状低密度,MRI表现为T1WI略低信号,T2WI及FLAIR序列呈高信号。病灶主要位于双侧枕顶叶,其次是额叶及颞叶,也可累及脑干、小脑及基底节区。经过合理治疗大部分病灶好转,其中一例患者合并散在出血。结论可逆性后部脑病综合征影像学表现有一定的特征,结合患者临床表现及病因,及时作出诊断,有利于提高治愈率。

Objective To analyze the CT and MRI imaging features of posterior reversible encephalopathy syndrome （PRES）,in order to improve the diagnostic accuracy of the disease. Methods The clinical material and radiologic data of 15 PRES patients were analyzed retrospectively.The examination included 10 females and 5 males, CT scan（9 patients）and MR scan （1 8 patients）, 2 patients were performed CT and MR scan both. Results The occipital and parietal lobes were the most common disease position of the PRES. The imaging findings of RPES presented as low density area on CT image. The lesions were displayed as hypointensity on T1WI and hyperintensity on T2WI and flair images. The location of lesions were parieto-occipital lobes mostly, followed by frontal and temporal lobe, brainstem, cerebellum and basal ganglia. Most 1esions were obviously reduced after treatment except for 1 patient with bleeding. Conclusion The characteristic imaging features could be assessed in patients with PRES. It will be helpful for prognosis if we can made the diagnosis in time.