子痫、子痫前期伴非典型部位可逆性后部白质脑病的影像学特征及相关因素分析

Imaging features and analysis of related factors of pre-eclampsia and eclampsia with atypical lesion of reversible posterior encephalopathy syndrome

目的分析子痫、子痫前期合并非典型部位可逆性后部白质脑病(Reversible Posterior Encephalopathy Syndrome,RPES)的影像学特征及相关因素。方法回顾性分析2010年1月~2015年12月盛京医院确诊的76例子痫、子痫前期合并可逆性后部白质脑病患者的临床与影像学资料,根据颅脑MRI受累部位不同分为典型病例组与非典型病例组,通过对患者的临床表现、生化指标及影像学特点总结,统计分析非典型部位受累的相关因素。结果 44例患者出现非典型部位受累,发生率57.9%,其中双侧基底节受累最为常见(39例,88.6%),其次为小脑受累(14例,31.8%),对非典型部位受累的相关因素进行Logistic回归分析显示,头痛(OR=6.37,CI 1.30~31.33,P=0.023)及痫性发作(OR=5.42,CI 1.68~17.47,P=0.005)与子痫、子痫前期合并非典型部位RPES有关。结论痫性发作、头痛与RPES非典型部位受累有关。

Objective To analyze the imaging features and related factors of pre-eclampsia and eclampsia with atypical lesion of reversible posterior encephalopathy syndrome（RPES）.Methods Retrospective analysis of 76patients’ imaging and clinical data,diagnosed pre-eclampsia and eclampsia with RPES from January 2010 to December 2015 in Sheng Jing hospital,according to the cranial MRI affected lesions,it was divided into the typical patient group and atypical patient group,based on the patients’ clinical manifestations,biochemical indicators and imaging characteristics,analyze the related factors of atypical lesion involved.Results 44 cases of patients had atypical lesions involved,the incidence is 57.9%,bilateral basal ganglia involvement is most common（39cases,88.6%）,followed by cerebellar involvement（14cases,31.8%）,when analyzing related factors with atypical lesion,logistic regression analysis showed that headache（OR=6.37,CI6.37 to 1.30,P=0.023）and seizure（OR=5.42,CI5.42 to 1.68,P=0.005）are related with atypical lesion involved.Conclusion Seizure and headache are related with atypical lesion involved.while,atypical lesion involvement do not relate with short-term prognosis.