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目的:探讨可逆性后部脑病综合征(PRES)的MRI影像学表现,提高对该病的诊断。方法:回顾性分析2012年10月至2015年4月在本院行MRI检查并经临床确诊为PRES的12例患者资料。结果:12例PRES患者头颅MRI表现为双侧后顶颞叶、枕叶对称性的散在小片状T1WI低、T2WI高信号,以白质受累为主,T2WI FLAIR序列显示更清晰,并部分皮层受累及;其中3例病灶累及脑干以及小脑半球,2例累及双侧基底节区。部分DWI高信号灶于ADC图上呈等或稍高信号。随访12例患者,经治疗后复查MRI显示病灶明显减少、消失,患者临床症状基本消失。结论:PRES的MRI表现具有一定特征性。该病发病部位以大脑后循环区域多见,双侧对称性分布,以血管源性水肿为主。MRI检查能够对该病进行早期诊断,帮助临床早期治疗。
Objective: To investigate the MRI features of reversible posterior encephalopathy syndrome (PRES) and to improve its diagnosis. Methods: The clinical data of 12 patients who underwent MRI examination from our hospital from October 2012 to April 2015 were retrospectively analyzed. Results: In 12 patients with PRES, head MRI showed bilateral posterior parietal temporal lobes. Symmetric occipital lobe patchy T1WI and T2WI hyperintensity were observed with white matter involvement. T2WI FLAIR sequence showed clearer and partial cortical involvement Among them, 3 lesions involved the brain stem and the cerebellar hemisphere, and 2 involved bilateral basal ganglia. Some DWI high signal stove showed equal or slightly higher signal on the ADC chart. Follow-up of 12 patients, after treatment, MRI showed lesions significantly reduced, disappeared, the patient’s clinical symptoms disappeared. Conclusion: The MRI of PRES shows some characteristics. The incidence of the disease to the brain area more common circulation, bilateral symmetry distribution, mainly to vasogenic edema. MRI can diagnose the disease early and help early clinical treatment.