可逆性胼胝体压部病变综合征5例分析并文献复习

目的探讨可逆性胼胝体压部病变综合征（RESLES）临床特点和核磁共振（MR）表现。方法回顾性分析5例经核磁共振扫描发现的胼胝体压部可逆性病变的影像学及临床学资料。结果5例患者均表现为局限于胼胝体压部的类圆形或椭圆形的孤立性病变，T1WI为稍低信号，T2WI为高信号，FLAIR为高信号，DWI为高信号，ADC为低信号，增强扫描无强化。5例患者中有前驱上呼吸道感染史2例；发热3例，头痛2例，头晕／视物模糊2例，意识障碍2例，呕吐1例；其中4例行腰穿脑脊液检查，2例正常，2例患者脑脊液白细胞增高分别为15／μl、160／μl。所有患者均经抗病毒、抗炎或激素等对症治疗后，除1例患者未复查外，其余4例患者在发病后10-20d后复查症状完全缓解，MR胼胝体压部异常信号完全消失。结论可逆性胼胝体压部病变综合征基础病因复杂，一般临床症状轻微，MR信号特点可逆，该病具有自限性，预后良好。

Obiective To investigate the clinical and MRI features of reversible splenial lesion syndrome （ RESLES ） . Methods Retrospective analysis the clinical and imaging date of 5 cases by the bain MRI finding of a reversible lesion in the splenium of corpus callosum. Results All five patients showed the single round or oval abnormal signal in the splenium of corpus callosum, T1WI showed slightly low signal, T2WI high signal, FLAIR high signal, DWI high signal, ADC low signal, and the enhanced scan revealed no enhancement.Two of five patients had the precursor of the upper respiratory tract infection; fever occurred in 3 cases, headache in 2 cases, dizzy or burred vision in 2 cases, disturbance of consciousness in 2 cases, and emesis in 1 case; 4 cases underwent lumbar puncture, 2 cases were nomal, 2 cases increased CSF WBC, respectively is 15/μl, 160/ μl.All patients receiced antiviral, anti-inflammatory or hormone therapy, except 1 patient was not review, the rest of the 4 patients clinical symptoms completely relieved from 10 to 20 days after the onset of disease, and the MR abnormal signal in the splenium of corpus callosum disappeared completely. Conclusions Reversible splenial lesion syndrome has a fundamental cause complex, with mild clinical symptoms, MR signal changes reversible, the lesion has self-limiting and good prognosis.