8例可逆性后部白质脑病综合征的CT、MR诊断分析

Diagnostic Analysis of Reversible Posterior Leukoencephalopathy Syndromes in CT and MRI

目的：分析和总结可逆性后部白质脑病综合征（reversible posterior leukoencephalopathy syndrome,RPLS）的CT、MRI表现,提高对此种疾病的认识水平。方法：回顾8例经临床、影像学及其治疗结果证实的RPLS的CT、MRI的影像学特点。结果：8例RPLS中,双侧枕顶叶白质均可见病灶,2例累及额颞叶,1例累及基底节,1例累及左小脑区。5例CT均表现为片状低密度,边界不清;MRI所有病例T1WI序列为低信号,T2WI、FLAIR为高信号,3例DWI为等或稍低信号,1例DWI为稍高信号。所有病例治疗短期（10~15 d）复查均见病灶吸收消失或明显缩小。结论：RPLS在CT、MRI上有一定的特点,尤其是MRI,表现为枕顶叶白质为主对称性发病,DWI等或稍低信号,ADC图高信号,结合临床病史、症状、体征,可以作出准确诊断。

Objective： To analyze the manifestations of reversible posterior leukoencephalopathy syndrome（ RPLS） in CT and MRI,to improve the understanding of this disease. Methods： CT and MRI imaging characteristics of the 8 patients were analyzed,who were confirmed to RPLS by clinical,imaging and treatment outcome of in the past two years. Results： The both bilateral occipital subeortieal white matter were affected in 8 cases of RPLS,frontal temporal lobe in 2 patient,basal ganglia in 1patient,the left cerebellum area in 1 patient. CT manifestations of 5 patients were low density flake,were not clear boundary; in all the cases,lesions appeard as hyperintense signals on FLAIR and T2- weighted images,hypointense signals on T1- weighted images; iso- intensity or slight low- intensity signal on DWI in 3 cases,slightly hyper- intensity signal on DWI in 1 cases. All cases of short- term treatment（ 10 ~ 15 days） were reviewed in lesions absorption which were disappeared or significantly narrowed. Conclusion： RPLS have certain CT and MRI characteristics,especially MRI; the lesion mainly symmetrically happenin the white matter of the pillow parietal,iso- intensity or slight low- intensity signal on DWI,hyper- intensity signal on ADC,and are combined with the clinical history,symptoms,signs,we can make an accurate diagnosis.