子痫脑病的影像学表现及其临床意义

Imaging Diagnosis and Clinical Significance of Eclampsia Encephalopathy

目的:对子痫引起的脑后部可逆性病变(子痫脑病)的影像学表现进行分析,加深对本病的认识。方法:回顾性分析我院2015年3月至2016年3月9例子痫脑病患者的临床表现、CT检查、MRI检查资料。9例行CT检查及磁共振成像(MRI)检查,5例于314天后复查MRI。结果:9例CT平扫为不规则形低密度区;MRI平扫T1WI上低信号,T2WI及T2Fliar呈高信号,扩散加权成像(DWI)病灶呈高信号,弥散表观系数(ADC)图上呈高信号。7例增强扫描均未见强化。3例行磁共振血管成像(MRA)均未发现特殊。1例患者磁共振静脉血管成像(MRV)检查正常。经治疗后5例复查MRI,3例显示病灶完全消失,病灶范围明显缩小者2例。病变主要以双侧顶枕叶为主,其次是额叶和颞叶,基底节区和小脑半球亦有累及。临床出现抽搐9例,头痛7例、视物模糊1例,意识障碍4例。治疗后症状缓解或消失,实验室指标恢复正常。结论:子痫脑病常急性起病,收缩压及舒张压均突然增高。影像学表现非常具有特征性,MRI扩散加权成像对鉴别诊断及早期明确诊断和指导治疗有重要的意义。

Objective：To improve understanding of clinical and imaging features of posterior reversible brain lesions caused by eclampsia. Methods：The clinical and radiologic data of nine patients were analyzed retrospec- tively,9 routine CT scan and MR1,5 cases were reviewed MRI in 3 -14 days. Reaults：CT scan irregularly shaped low density areas, MRI scan showed low signal on T1WI, T2WI showed high signal and T2Fliar, DWI： Lesions showed high signal,such as high signal on ADC maps;enhanced scan showed no strengthen,3 cases of MRA and 1 cases of MRV examination were normal. After review of the treatment of 5 cases,3 cases showed lesions completely disappearing,the range of lesions significantly reduced in 2 cases. Lesions mainly were in the bilateral occipital,followed by the frontal and temporal lobes, basal ganglia and cerebellum were also involved. Patients presented convulsion （9 cases）, headache （7 cases）, blurred vision （ 1 case）, disturbance of consciousness （4 ca- ses）. The clinical symptoms were totally shown favorable prognosis after treatments. Laboratory index returned to normal. Conclusions： Eclampsia encephalopathy is a pregnant perinatal serious complication, endangers the ma- ternal and fetal safety and its imaging findings has typical characteristic,MRI diffusion imaging is of great signifi- cance to the differential diagnosis, to improve the understanding of the disease, and to guide treatment.