脑后部可逆性脑病综合征临床特征及MRI表现

摘要

目的：分析脑后部可逆性脑病综合征的临床特征及MRI表现。方法：2012年12月至2014年2月在我院治疗的6例PRES患者，分析其临床及MRI表现特点。6例患者中，女性5例，男性1例，均行MR T1WI、T2WI、水抑制序列（FLAIR）；5例患者行MR静脉成像（MRV）；1例患者行MR扩散加权成像（DWI）。结果：本组6例患者中，4例继发于妊娠高血压，慢性肾炎伴肾功能不全透析1例，系统性红斑狼疮1例，其中癫痫发作3例。6例均有头痛头晕，意识障碍2例，轻偏瘫1例。M R I表现：双侧顶叶、枕叶（6例）、基底节区（2例）、额叶（1例）、颞叶（1例）多发异常信号。病灶主要位于双侧顶枕叶皮质下白质内，有2例患者皮层亦受累，在T1W I病灶表现为等或略低信号，T2WI及FLAIR呈高信号。FLAIR序列显示病灶最佳。6例患者经治疗后随访MRI显示所有患者病灶范围、数目逐渐变小、减少或消失。结论：PRES临床主要表现包括头痛头晕、意识障碍或癫痫发作。MRI表现为T1WI等或略低信号、T2WI及FLAIW高信号。病变为血管源性水肿。及早诊断及早治疗十分重要。%Objective:To analyzed clinical features and MRI performance of posterior reversible encephalopathy syndrome.Methods:Collect all prtients with PERS treated in our hospital from 2006 to 2011 to analysis the clinical and MRI presentation of PRES. This teaminclude 5 women and only one man. All of them had MR imaging(T1WI、T2WI、FLAIR),three cases had MRV, and one cases had MR imaging DWI.Resulte:In this team,four cases caught PRES after pregnancy-inducedhy pretension. One case got PRES after systemic lupus erythematosus,three of them got seizures, all of them got headaches, two of them got disturbance of consciousness, and one of them had hemiplegia.MRI demonstrated multiple lesions located in bilateral parieto-occipital(6 cases),bilateral basal ganglia(2 cases),and bilateral frontal lobes(1 case).The lesions were prominent within white matter, some of them involved gray matter(2 cases).Lesions appeared as hyperintense signals on FLAIR and T2-weighted images,isointense or mildly hyperintense signals on T1-weighted images.FLAIR has advantages to display lesion in PRES. All of them received treatment had MR imaging show that lesions of PRES had become smallse or even vanished. Conclusion:PRES clinical represents mainly include headaches,seizures or disturbance of consciousness. MRI showed T1WI isointense or mild hypointense, T2WI and FLAIR hyperintense. Lesions are vasogenicedema. Early diagnosis and early treatment is very important.