可逆性胼胝体压部病变综合征4例临床特点分析

Clinical characteristics of reversible corporis callosi splenium lesion syndrome in four patients

目的分析可逆性胼胝体压部病变综合征患者的临床特征和影像学演变特点。方法分析2013年3月至2016年8月我院收治的4例可逆性胼胝体压部病变综合征患者的临床资料和影像学资料的特点。结果 4例患者发病年龄分别为2岁、18岁、52岁、62岁,其中3例患者发病前存在前驱感染症状,1例患者脑脊液提示病毒感染可能。4例治疗前头颅MRI均表现为胼胝体压部类圆形边界清楚的等或稍长T_1、长T_2信号,DWI高信号,病变周围无明显水肿、无明显占位效应。病例四患者无任何感染证据,相同性质病灶累及双侧半卵圆中心,治疗后复查MRI均显示病灶消退。4例患者临床表现差异大,但均伴有低钠血症。结论可逆性胼胝体压部病变综合征是一种急性单病程的非特异性脑炎或脑病,影像学表现为胼胝体压部可逆的类圆形病灶,常伴低钠血症,该病临床异质性大,但预后良好。

Objective To analyze the clinical features and imaging characteristics of patients with Reversible splenium corporis callosi lesion syndrome （RESLES） .Methods The clinical and radiological datas of 4 patients （hospitalized in our hospital during March 2013 and August 2016） with RESLES diagnosed in our hospital were summarized. Results The age of onset of the four patients were 2, 18, 52 and 62 years old. 3 cases with infection symptoms prior to the RESLES onset, 1 case of them with cerebrospinal fluid changes which indicate the viral infection. The cerebral MRI of 4 cases showed that the splenium corporis callosi presented with round clear boundary lesions which had slightly long T1 and long T2 signal, and high signal in DWI without edema and significant enhanced effect, however, the 4 cases had no evidence of infection, and lesions of the same nature implicated bilateral semiovale centrum. And MRI showed the lesions subsided in short term after the treatment. Four cases of patients had significant differences in clinical manifestations, but all of them are accompanied with hyponatremia. Conclusions RESLES is an acute nonspecific encephalitis or encephalopathy, with single disease course, the imaging findings are reversible circular lesions of the corpus callosum, may often accompanied by hyponatremia. The disease is clinically heterogeneous but has a good prognosis.