可逆性后部脑病综合征的MRI表现

Reversible posterior encephalopathy syndrome: evaluation of MRI fidings

目的探讨可逆性后部脑病综合征(PRES)MRI表现。方法回顾性分析8例经临床随访证实为可逆性后部脑病综合征病例的临床表现、临床病程、预后及MRI表现。对8例典型可逆性后部脑病患者行常规MRI扫描及DWI扫描,分析其MRI特征。结果 MRI示双侧顶枕叶、双侧额叶(3例)、双侧基底节区以及小脑半球(1例)、双侧颞叶、双侧顶枕叶(92例)、双侧大脑半球皮髓质交界区(1例),一侧额叶(1例)多发异常信号,发生于大脑半球的病变主要累及皮层、皮层下白质,双侧基本对称,T1WI呈等或略低信号,T2WI及T2FLAIR呈高信号,DWI呈低信号、等信号,ADC图呈高信号、等信号,随访观察异常信号大部分消失。结论可逆性后部脑病综合征MRI表现及DWI表现特异,早期正确诊断和及时治疗是临床病程逆转的关键。

Objective： To eveluate the MRI findings of Reversible posterior encephalopathy syndrome（PRES）. Methods： Retrospectively analyzing MRI findings of 8 cases of PRES confirmed by clinical diagnosis and follow up. Results：MRI shows iso-and hypo-intense signal on T1WI,hyper-intense signal on T2WI and FLAIR,iso-and hyper-intense signal on DWI. The lession locate at bilateral parietal occipital lobe,bilateral frontal lobe（3 cases）,bilateral basal ganglia region and cerebellar hemisphere（1 cases）,bilateral temporal lobe,bilateral occipital lobe（2 cases）,bilateral cerebral cortex medulla junction area（1 cases）,one side frontal lobe（1 case）. The cortex and subcortical white matter was involved in these cases,and most lesions are symmetric. Conclusion： PRES lesions can be shown as iso-and hyper-intense signal on DWI. Reversible posterior encephalopathy syndrome MRI manifestations and DWI performance specific,early diagnosis and timely treatment is the key to the clinical course of disease reversal.