脑后部可逆性脑病综合征的MRI特征和临床价值

摘要

目的 探讨脑后部可逆性脑病综合征的MRI特征和临床价值.方法 回顾性分析25例脑后部可逆性脑病综合征(PRES)孕妇的MRI资料并随访观察.结果 所有病例MRI均显示脑实质内多发性的斑片状T1WI低信号、T2 WI及FLAIR高信号病灶,大致对称分布.病灶分布以顶枕叶白质为主,额颞叶、基底节、小脑、脑干及皮层灰质也可受累.DWI (b=1000)显示高信号病灶9例,其中ADC图呈低信号3例,提示形成脑梗死.随访发现22例病灶于治疗后短期内恢复,病灶范围大、分布广或于DWI、ADC图显示弥散受限者预后较差.结论 孕妇PRES的MRI表现具有显著的特征,MRI对早期诊断、判断预后和指导治疗有重要价值.%Objective To investigate the characteristics and clinical value of MRI in pregnant women with posterior reversible encephalopathy syndrome (PRES).Methods 25 cases of PRES with MRI data were retrospectively analyzed and were followed up.Results In all the patients,MRI revealed symmetrical multiple patchylike lesions which presented hypointense on T1 WI imaging,hyperintense on T2 WI and FLAIR imaging,and located predominantly in the parietal and occipital lobe.The lesions demonstrated high signal in 9 cases on DWI(b=1 000),of which 3 cases had low signal lesions on ADC maps indicating cerebral infarction.After treatment and followed-up,22 cases had better prognosis and recorvered in a short time after treament.3 cases with lesions widely distriduted or showed high singal on DWI and low signal on ADC maps had poor prognosis.Conclusion PRES has distinctive characteristics.The MR imaging has an important value for the early diagnosis,judging the prognosis and guiding the treatment of the PRES.