介入治疗脑血管病相关对比剂脑病临床及影像学表现:7例报告

目的 观察介入治疗脑血管病相关对比剂脑病（CIE）的临床及影像学表现。方法 回顾性分析7例因脑血管病接受介入治疗后发生CIE患者，观察其临床及影像学表现。结果 7例介入治疗包括4例动脉瘤栓塞术、1例右侧大脑中动脉介入取栓术、1例左侧大脑中动脉取栓术联合球囊扩张成形术及1例颈内动脉狭窄球囊扩张成形术。术后12 h内6例新发偏瘫、1例偏瘫加重，出现癫痫及视力障碍（皮质盲）各4例，意识障碍3例，失语1例；影像学表现包括MRI显示术侧大脑皮层肿胀、脑组织呈弥散加权成像（DWI）高信号3例、两侧枕额叶DWI高信号1例，CT显示3例术侧脑沟高密度影。经降颅压等对症支持治疗2~5天后新发症状消失，2~14天后体征好转或消失；6例治疗后9~48 h、1例治疗后5天复查显示上述异常征象减弱或消失，脑血管MR造影（MRA）颅内动脉均未见狭窄及闭塞。结论 CIE临床及影像学表现均具有一定特异性，及时确诊并给予相应治疗预后较好。

Clinical features and imaging findings of cerebrovascular intervention related contrast-induced encephalopathy: Report of 7 cases

Objective To observe the clinical and imaging findings of cerebrovascular intervention related contrast-induced encephalopathy (CIE). Methods Data 7 patients with CIE after cerebrovascular interventional therapy of cerebrovascular diseases (CVD) were retrospectively analyzed, and the clinical and imaging features of CIE were observed. Results Cerebrovascular interventions included 4 cases of aneurysm embolization, 1 case of right middle cerebral artery interventional thrombectomy, 1 of left middle cerebral artery thrombectomy combined with balloon dilatation and 1 balloon dilatation for internal carotid artery stenosis. Within 12 h after interventions, new hemiplegia occurred in 6 cases, aggravated hemiplegia was noticed in 1 case, while epilepsy and visual impairment (cortical blindness) each happened in 4 cases, consciousness disorder and aphasia was observed in 3 cases and 1 case, respectively. MRI findings included cerebral cortex swelling, high diffusion weighted imaging (DWI) signal intensities in 3 cases and high DWI signal intensities in bilateral occipital frontal lobe in 1 case, while CT showed high density shadow in sulcus in 3 cases. After symptomatic support therapies such as intracranial pressure lowering therapy, the new symptoms disappeared 2-5 days, and the signs improved or disappeared 2-14 days later. Weakened or disappeared abnormal signs were observed in 6 patients 9-48 h and in 1 patient 5 days after treatments on MRI and/or CT, and MR angiography (MRA) showed no stenosis nor occlusion of intracranial arteries. Conclusion The clinical and imaging findings of CIE were somehow specific. After timely diagnosis and treatment, the prognosis of CIE might be good.