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子痫性脑病的MRI特点分析

作者:孙 理 普福顺 杨富辉 罗家滨 李 平 杜 军

所属单位:云南省红河州第一人民医院放射科(云南 蒙自 661199)

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摘要

目的探讨子痫性脑病的MRI特 点。方法 分析9例子痫性脑病患者的MRI 资料。9例行MRI检查,经临床治疗后行 MRI复查。结果 9例MRI显示双侧大脑半球 后部白质区为主的对称性斑片状影,病灶 均呈两侧大致对称性分布,多数病灶位于 顶枕叶皮层下白质区、颞叶及小脑半球; 病灶T1WI主要呈低、稍低信号、T2WI呈稍 高信号、FLAIR呈较高信号、DWI呈稍高信 号,MRA和MRV均未见明显异常;经对症治 疗后神经系统症状完全消失,复查MRI显 示仅1例基底节区尚残余少许病灶,其余 病灶均已消失。结论 子痫性脑病的MRI表 现具有一定特征性,提高对该病的临床及 MRI特点的认识,对于该病早期诊断、及 时治疗和疗效评估具有非常重要的意义。

Objective To investigate the MRI features of eclamptic encephalopathy. Methods Analyze the MRI performance of 9 cases of eclamptic encephalopathy. A total of 9 cases underwent MRI examination, all cases had been follow-up after clinical treatment. Results All the 9 cases of MRI showed the symmetrical patches of the white matter in the posterior portion of the bilateral cerebral hemisphere, the lesions were generally distributed on both sides, most of the lesions located in the top occipital subcortical white matter area, temporal lobe and cerebellum, the lesion on T1WI was low or slightly lower signal, and was slightly higher signal on T2WI, higher signal on FLAIR, slightly higher signal on DWI, and MRA and MRV showed no obvious abnormality. After treatment, the neurological symptoms completely disappeared, and the MRI revealed that only one of the base regions remained a few lesions, and the other lesions had disappeared. Conclusion The MRI findings of eclampsia encephalopathy has certain characteristic. Improving the understanding of clinical and MRI features of eclampsia is very important for early diagnosis, timely treatment and evaluation of the disease.

【关键词】子痫;脑;磁共振成像

【中图分类号】R742 R445.2

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2018.10.010

前言

子痫性脑病(eclamptic encephalopathy,EE)是子痫累及中枢神 经系统的临床影像综合征[1]。近年来,高龄孕产妇人数急剧上升,高 龄妊娠并发子痫的患者亦随着增多,子痫性脑病是我国孕产妇死亡的 重要原因[2-4]。其典型临床表现为剧烈头痛、烦躁、谵妄、视物模糊、 惊厥抽搐、恶性呕吐、意识障碍甚至昏迷等症状,常有血压高、起病 急、进展快、但神经系统阳性体征较少的特点。及时、有效治疗可治 愈,若不及时治疗可致不可逆性脑部损害,甚至危及生命[1-4]。因此, 及早准确诊断至关重要。MRI对脑部结构显示具有较高的敏感性,现已 成为该病的最佳影像学检查方法和随访手段[1]。本文通过对9例经临床 证实为子痫性脑病的MRI表现进行分析、研究,初步显示出MR的临床应 用潜力。