摘要
目的分析可逆性后部脑病综合 征的CT及MR影像学表现,提高对该病的诊 断。方法 回顾性分析15例可逆性后部脑 病综合征患者临床资料及影像学资料,其 中女性10例,男性5例,9例患者行CT平 扫,8例患者行MR扫描,其中2例患者同时 行CT及MR扫描。结果 可逆性后部脑病综 合征表现为以枕顶叶白质区为主的异常 改变,CT图像呈片状低密度,MRI表现为 T1WI略低信号,T2WI及FLAIR序列呈高信 号。病灶主要位于双侧枕顶叶,其次是额 叶及颞叶,也可累及脑干、小脑及基底节 区。经过合理治疗大部分病灶好转,其中 一例患者合并散在出血。结论 可逆性后 部脑病综合征影像学表现有一定的特征, 结合患者临床表现及病因,及时作出诊 断,有利于提高治愈率。
Objective To analyze the CT and MRI imaging features of posterior reversible encephalopathy syndrome (PRES),in order to improve the diagnostic accuracy of the disease. Methods The clinical material and radiologic data of 15 PRES patients were analyzed retrospectively.The examination included 10 females and 5 males, CT scan(9 patients)and MR scan (1 8 patients), 2 patients were performed CT and MR scan both. Results The occipital and parietal lobes were the most common disease position of the PRES. The imaging findings of RPES presented as low density area on CT image. The lesions were displayed as hypointensity on T1WI and hyperintensity on T2WI and flair images. The location of lesions were parieto-occipital lobes mostly, followed by frontal and temporal lobe, brainstem, cerebellum and basal ganglia. Most 1esions were obviously reduced after treatment except for 1 patient with bleeding. Conclusion The characteristic imaging features could be assessed in patients with PRES. It will be helpful for prognosis if we can made the diagnosis in time.
【关键词】可逆性后部脑病综合征;X线计算机体层摄影术;磁共振成像;诊断
【中图分类号】R445.2;R445.3;R742.
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.09.013
前言
可逆性后部脑病综合征(posterior reversible encephalopathy syndrome, PRES)是由有多种因素导致临床-影像学综合征。临床主要 表现为头痛、反应迟钝、智能改变、癫痫和失明。上述症状见于高血 压、先兆子痫/子痫、肾功能失代偿、水钠儲留和应用免疫抑制剂及化 疗药物。该病起病急,症状较重,但如能及时进行合理治疗,大部分 患者临床症状及影像学表现均具有可逆性,因此及早作出正确的诊断 尤为重要。
中国CT和MRI杂志
第13卷, 第 9 期
2015年09月
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