可逆性后部白质脑病综合征16例临床特点及影像学分析

摘要

目的:探讨可逆性后部白质脑病综合征(reversible posterior leukoencephalopathy syndrome,RPLS)的临床和影像学特点.方法:本研究为回顾性临床观察.共分析16例可逆性后部白质脑病综合征患者的临床资料.结果:16例患者病因多种,妊娠高血压综合征及先兆子痫7例,继发性高血压3例,原发性高血压3例,肾功能不全3例.主要临床表现视觉障碍、头痛、精神异常和癫痫发作.多数患者头颅 MRI表现为双侧大脑后部白质T1WI呈低或等信号,DWI呈等或稍高信号,T2WI和 FLAIR像呈高信号,ADC呈高信号,双侧对称或不对称;予以积极对症处理后患者临床症状及影像学表现明显好转.结论:RPLS的病程具有可逆性,脑后部白质损害是其主要特征,及时的诊断与治疗是本病恢复的关键.%Objective:To investigate the reversible posterior leukoencephalopathy syndrome ( reversible posterior leukoencephalopathy syndrome, RPLS ) : clinical and imaging features.Methods:The study was a retrospective clinical observation. Analysis ofl6 cases of reversible posterior leukoencephalopathy syndrome in patients with clinical data.Results:16 cases of patients with a variety of etiologies, pregnancy-induced hypertension and preeclampsia in 7 cases, secondary hypertension in 3 cases,3 cases of essential hypertension, renal insufficiency in 3 cases. The main clinical manifestations of visual disturbance, headache, mental disorder and epileptic seizures. The majority of patients with MRI scan showed bilateral posterior cerebral white matter T1WI had low-intermediate signal, DWI were equal or slightly high signal, like T2WI and FLAIR showed high signal intensity, ADC showed high signal, bilateral symmetry or asymmetry; be positive after symptomatic treatment in patients with clinical symptoms and imaging performed significantly better. Conclusion:RPLS in the course of the disease is reversible, posterior white matter damage is its main characteristic, and timely diagnosis and treatment of this disease is the key to recovery.