儿童可逆性胼胝体压部病变综合征的MRI表现

MRI appearance of reversible splenial lesion syndrome in children

目的探讨儿童可逆性胼胝体压部病变综合征（RESLES）的MRI诊断价值。方法回顾性分析14例RESLES患儿的临床及MRI影像资料。男4例、女10例；年龄11～35个月，平均（20±3）个月。所有患儿均进行MRI平扫，2名高年资儿童影像医师独立对图像进行分析，并协商达成一致意见。结果14例患儿首诊头颅MRI显示病灶均为胼胝体压部单发异常信号影。T1WI呈等信号10例、稍低信号者4例；14例T2WI均为高信号，FLAIR T2WI呈高或稍高信号影，病灶呈圆形、椭圆形及不规则片状影，边界模糊；DWI均呈圆形或椭圆形明显高信号，边界清晰，病变周围无明显水肿及占位效应。14例患儿经治疗后，8例于7—14d后复查MRI，5例胼胝体压部病灶异常信号消失，3例原病灶范围明显缩小，高信号减低，边界变模糊。5例患儿1—2个月后复查MRI，显示胼胝体压部病灶消失。1例经治疗后临床症状消失，未复查MRI。结论儿童RESLES临床表现缺乏特异性，头颅MRI表现为胼胝体压部可逆性的孤立病灶，具有特征性，可为临床诊疗提供可靠依据。

Objective To investigate the diagnostic value of MRI in reversible splenial lesion syndrome （RESLES） in children. Methods The clinical and MRI imaging data of 14 cases of RESLES in children were retrospectively reviewed. There were 4 males and 10 females, aging 11 to 35 months. Average age was （20±3） months. MRI studies were conducted in all the cases. Two experienced doctors analyzed independently the images and reached consensus. Results Fourteen cases showed the single abnormal signal in the splenial of corpus callosum on the initial cerebral MR1. Lesions in 10 of 14 cases appeared as isointensity on %WI, hypo-intensity in 4 cases. Lesions in 14 cases were appeared as hyper-intensity on T2WI, hyper-/slightly hyper-intensity on FLAIR T2WI. The lesions were round, oval or irregular, with fuzzy boundary. DWI showed round or oval high signal with clear boundary. No edema around the lesion and no occupying effect were detected. After treatment, 8 of 14 cases were reviewed after 7-14 d, and the abnormal signal in the corpus callosum disappeared in 5 cases, while the range was significantly reduced in 3 cases. MRI were reexamined after 1-2 months in 5 cases, and the lesions disappeared in the corpus callosum. One case didn＇t have MRI examination again after treatment and the clinical symptoms disappeared. Conclusions The clinical manifestations of RESLES in children are lack of specificity. And the cerebral MRI imaging is characterized by the reversible solitary lesion of the splenium, which can provide a reliable basis for clinical diagnosis and prognosis.