可逆性胼胝体压部病变综合征的临床与MRI表现

Clinical and MRI Findings of Reversible Corpus Callosum Lesion Syndrome

目的:分析和总结可逆性胼胝体压部病变综合征的临床与MRI表现。方法:选择笔者所在医院2015年1月-2018年8月收治的10例可逆性胼胝体压部病变综合征患者作为研究对象,回顾性分析患者的临床资料和MRI资料。结果:可逆性胼胝体压部病变综合征的主要临床表现为发热、头晕、头痛、咳嗽、呕吐、意识障碍、肢体麻木、行为异常等。行MRI扫描后,可见大多数患者胼胝体压部病灶形状为圆形或椭圆形,少数为长条形或斑片状,且病灶边界清楚,呈孤立性,主要位于中央区对称性。FLAIR与T2WI均为稍高信号,T1WI为稍低信号或等信号,DWI呈明显均匀高信号,扩散系数(ADC)图表现为低信号,所有患者均未见明显囊性和坏死改变,病变周围无明显占位效应及水肿。行增强扫描后,病灶未出现明显强化。经MRI检查后,根据检查结果给患者提供对症的抗感染、抗病毒治疗1～4周后,再对患者行MRI检查,上述MRI表现消失。结论:可逆性胼胝体压部病变综合征病因复杂,且缺乏特异性的临床表现,通过对具有前驱症状的患者行MRI检查,根据MRI表现才能尽早对患者确诊和治疗,进而才能提高其预后效果。

Objective:To analyze and summarize the clinical and MRI findings of reversible corpus callosum lesion syndrome.Method:Ten patients with reversible corpus callosum lesion syndrome admitted to our hospital from January 2015 to August 2018 were selected as subjects.The clinical data and MRI data of the patients were retrospectively analyzed.Result:The main clinical manifestations of reversible corpus callosum lesion syndrome were symptoms such as fever,dizziness,headache,cough,vomiting,disturbance of consciousness,numbness of the limbs,and abnormal behavior.After MRI scan,it could be seen that the shape of the lesions of the corpus callosum was circular or elliptical in most patients,and a few were long or patchy,and the lesions were clearly and isolated,mainly located in the central region.FLAIR and T2WI were slightly higher signals,T1WI was slightly lower signal or equal signal,DWI was obviously uniform high signal,diffusion coefficient(ADC) diagram showed low signal,and all patients had no obvious cystic and necrotic changes around the lesion.No obvious placeholder effect and edema.After the enhanced scan,there was no significant enhancement of the lesion.After MRI examination,according to the results of the examination to provide patients with symptomatic anti-infective,anti-viral treatment 1-4,and then MRI examination of the patient,the above MRI performance disappeared.Conclusion:Reversible corpus callosum lesion syndrome is complicated and lacks specific clinical manifestations.MRI examination of patients with prodromal symptoms can confirm and treat patients as early as possible according to MRI performance,so as to improve their prognosis.