可逆性后部脑病综合征的MRI特点及其鉴别诊断价值

MRI Features of Posterior Reversible Encephalopathy Syndrome and Its Differential Diagnostic Value

目的分析可逆性后部脑病综合征(PRES)的MRI特点及其鉴别诊断价值。方法回顾性分析滨州医学院烟台附属医院2011年1月—2014年11月收治的18例PRES患者的MRI检查结果,并总结其鉴别诊断要点。结果18例PRES患者MRI检查结果显示:病灶多集中于左顶叶(占38.88%)和双侧顶叶(占22.22%);T1WI多呈稍低或不明显信号,T2WI及液体衰减反转恢复序列(FLAIR)均呈高信号,扩散加权成像(DWI)多呈等信号或稍低信号,ADC呈高信号,磁共振静脉成像(MRV)均未见明显异常,大部分患者增强扫描未见异常强化,仅7例患者左顶叶病灶出现多发性小点强化。结论 PRES患者MRI异常信号多位于顶叶,结合DWI、ADC、MRV有助于与其他脑部疾病进行鉴别诊断。

Objective To analyze the MRI features of posterior reversible encephalopathy syndrome（ PRES） and its differential diagnostic value. Methods From January 2011 to November 2014 in Yantai Affiliated Hospital of Binzhou Medical College,a total of 18 patients with PRES were enrolled in this study, their MRI examination results were retrospectively analyzed,and the key points of differential diagnosis was summarized. Results MRI findings showed that,most nidus located in left parietal lobe（accounted for 38. 88%）and bilateral parietal lobes（accounted for 22. 22%）;most T1WI showed slightly low or unconspicuous signal intensity,T2WI and FLAIR showed increased signal intensity,most DWI showed isointensity or slightly low signal intensity,ADC showed increased signal intensity,MRV did not show obvious abnormality;most enhancement scanning did not show obvious abnormality,7 cases′left parietal lobes showed multiple little points increased signal intensity. Conclusion Of PRES patients,the abnormal MRI signals mostly located in parietal lobe,combination with DWI,ADC,MRV is helpful to differentially diagnose PRES from other cerebral diseases.