Objective To elucidate the clinical and MRI features of reversible posterior encephalopathy syndrome (PRES) in children and adolescents,and to analyze the similarities and differences between children and adults in etiological factors, pathogenesis and MRI characteristics. Methods Clinical records and MR scanning results of 8 children with PRES were analyzed retrospectively. Results All of 8 children suffered from underlying diseases, including systemic lupus erythema-tous (n = 2), acute lymphoblastic leukemia (n=l), scleroderma (n=l), nephrotic syndrome (n = 3) or idiopathic epilepsy (n=l), and were treated with glucocorticoid, immunosuppressant or cytotoxic drug. MR showed the lesions were symmetrical and mainly involved the subcortical regions of parietal-occipital lobes and portion cortical, presenting as low signal on T1WI and high signal on T2WI and T2 FLAIR sequence. The lesions also appeared in temporal lobe, frontal lobe, basal ganglia, brainstem and cerebellum. Clinical conditions improved in all of 8 children after effective therapy, and MRI abnormalities disappeared completely in 4 cases. Conclusion Glucocorticoid, immunosuppressant or cytotoxic drug will be the crucial causations of PRES in children and adolescents. MRI features is helpful for diagnosis of PRES.%目的 分析儿童和青少年可逆性后部脑病综合征(PRES)的临床资料和MRI特征,探讨其病因、发病机制及MRI表现与成人的异同.方法 回顾性分析8例PRES患儿的临床资料及MR扫描结果.结果 8例患儿均有基础性疾病,其中系统性红斑狼疮2例,急性淋巴细胞性白血病1例,硬皮病1例,肾病综合征3例,原发性癫痫1例；均接受糖皮质激素、免疫抑制剂或细胞毒性药物治疗.MRI表现为以顶枕叶皮层下白质为主的片状对称性长T1长T2信号、T2FLAIR序列呈高信号灶,部分病灶累及皮层；颞叶、额叶、基底节区、脑干或小脑亦可见信号相同的小片状病灶.经有效治疗后,患儿神经系统症状均消失,其中4例复查头颅MRI,可见脑内病灶均消失.结论 使用糖皮质激素、免疫抑制剂及细胞毒性药物可能是引起儿童和青少年PRES重要原因,其特征性MRI表现有助于临床诊断PRES.
展开▼
