目的 分析可逆性后部白质脑病 综合征(RPLS)30例的临床特征及影像学特 点，为其诊断与治疗提供参考。方法 选 取2014年7月至2015年9月我院收治的RPLS 患者30例为研究对象，均行CT及MRI检 查，搜集其临床资料，分析RPLS的临床特 征、影像学特点及CT与MRI联合诊断的灵 敏度、特异度、准确度。结果 RPLS均呈 急性起病，主要表现为癫痫(26.67％)、 头痛头晕(20.00％)、抽搐(23.33％)、视 物模糊(6.67％)、意识障碍(10.00％)、 恶心呕吐(13.33％)，可伴高血压、肾功 能损伤；影像学CT示脑皮质下低密度影， MRI中T1WI等或稍低信号，T2WI及FLAIR 呈高信号，经治疗后双侧枕叶、右侧基 底核区斑片状高信号明显吸收好转；CT 联合MRI诊断RPLS的灵敏度为91.67％， 特异度为83.33％，准确度为90.00％， 较CT(66.67％、83.33％、70.00％)及 MRI(79.17％、66.67％、76.67％)高，CT 诊断灵敏度最低(P＜0.05)。结论 RPLS以 癫痫、抽搐、头痛头晕为主要表现，影像 学CT见脑皮质下低密度影，而MRI-T1WI呈 等或稍低信号，T2WI及FLAIR呈高信号。

Objective To analyze the clinical features and imaging features of 30 patients with reversible posterior leukoencephalopathy syndrome (RPLS), and provide reference for the diagnosis and treatment of the disease. Methods Thirty patients with RPLS treated in our hospital between July 2014 and September 2015were selected as study subjects. All patients were examined by CT and MRI, and their clinical data were collected. The clinical features, imaging features and the sensitivity, specificity and accuracy of CT combined with MRI in the diagnosis of RPLS were analyzed. Results RPLS showed acute onset and the mainly manifestations included epilepsy (26.67%), headache and dizziness (20.00%), convulsion (23.33%), blurred vision (6.67%), disturbance of consciousness (10.00%) and nausea and vomiting (13.33%), may beingcomplicated with hypertension and renal injury. CT showed low density shadow under cerebral cortex. MRI showed equal or slightly low signal on T1WI, high signal on T2WI and FLAIR. After treatment, patchy high signal in bilateral occipital lobes and right basal nucleus region was significant absorbed and improved; The sensitivity, specificity and accuracy of CT combined with MRI in the diagnosis of RPLS (91.67%, 83.33%, 90.00%) were higher than those of CT (66.67%, 83.33%, 70.00%) and MRI (79.17%, 66.67%, 76.67%), and the sensitivity of CT was the lowest (P<0.05). Conclusion The main manifestations of RPLS are epilepsy, convulsions, headache and dizziness. CT shows low density shadows under the cerebral cortex, while the MRI-T1WI shows equal or slightly low signal and T2WI and FLAIR show high signal.