妊娠期高血压脑后循环可逆性脑病综合征MRI表现及诊断价值

MRI Features and Diagnostic Value of Posterior Reversible Encephalopathy Syndrome Caused by Pregnancy-Induced Hypertension

目的:分析妊娠期高血压脑后循环可逆性脑病综合征(PRES)的MRI特征及诊断价值。方法:回顾性分析20例妊娠期高血压患者临床及MRI资料。所有患者治疗前行MRI平扫及DWI扫描。结果:本组伴有PRES 9例(45%),不伴有PRES 11例。MRI显示有PRES组共30个主要病灶,枕叶12个,胼胝体压部3个,顶叶半卵圆中心5个,颞叶5个,额叶3个。病灶主体位于皮质下白质、部分邻近皮质亦有受累。T_1WI等、稍低信号,T_2WI、T_2WI/flair稍高信号。DWI以等、稍高信号为主,ADC以等、稍低信号为著。T_2WI/flair发现病灶数最多,2例仅在DWI序列上显示清晰。结论:妊娠期高血压PRES MRI具有一定的特征性,DWI结合T_2WI/flair能发现更多病灶。

Objective： To investigate the MRI features and the diagnostic value of posterior reversible encephalopathy syndrome（PRES） caused by pregnancy-induced hypertension（PIH）. Methods： Clinical and MRI data of 20 cases of PIH were retrospectively reviewed. All cases were examined by MRI scanning and diffusion weighted imaging（DWI） before drug therapy. Results： There were 9 cases with PRES（45%） and 11 cases without PRES. MRI revealed 30 lesions in the PRES group： 12 in the occipital lobe, 3 in the corpus callosum, 5 in the parietal lobe centrum semiovale, 5 in the temporal lobe, and 3 in the frontal lobe. Lesion location involved sub-cortical white matter and neighboring portions of the cortex. Lesions were mildly hypointense on T_1WI and mildly hyperintense on T_2WI and T_2WI/flair. Lesions were mildly hyperintense on DWI and hypointense on apparent diffusion coefficient（ADC）. T_2WI/flair detected the highest number of lesions. Two cases were only able to be clearly imaged on the DWI sequence. Conclusion： MRI features of PRES caused by PIH display certain characteristics; DWI combined with T_2WI/flair can detect more lesions.