可逆性后部白质脑病综合征的临床及影像学特点

目的探讨可逆性后部白质脑病综合征(RPLS)的临床及影像学特点。方法回顾性分析16例RPLS患者的临床资料。结果患者均为急性起病,其中继发于高血压脑病7例,妊娠子痫9例。患者均出现血压明显升高,其中出现头痛9例,意识障碍9例,癫痫发作13例,视力模糊6例。16例患者MRI均表现为双侧枕叶和/或额、颞、顶叶对称或不对称的T1低信号,T2高信号;其中累及顶叶13例(81.3%),枕叶12例(75.0%),额叶9例(56.3%),颞叶5例(31.3%),小脑4例(25.0%)。弥散加权成像(DWI)显示等/低信号14例,异常高信号2例。所有患者经对症治疗均痊愈。结论 RPLS以血压升高、头痛、视觉异常、意识障碍、癫痫发作为主要临床表现。MRI表现双侧枕叶和/或额、颞、顶叶对称或不对称的T1低信号,T2高信号,经治疗预后良好。

Clinical and imaging features of reversible posterior leukoencephalopathy syndrome

Objective To explore the clinical and imaging features of reversible posterior leukoencephalopathy syndrome(RPLS).Methods The clinical data of 16 RPLS patients were analyzed retrospectively.Results All the patients were acute onset,and secondary to hypertensive encephalopathy in 7 cases,eclampsid gravidarum in 9 cases.All the patients were blood pressure significantly elevation.There were headache in 9 cases,consciousness disorders in 9 cases,grand mal epilepsy in 13 cases,blurred vision in 6 cases.The brain MRI in 16 patients was showed that symmetric or asymmetric low signal on T1WI and high signal on T2WI in bilateral occipital lobule and/or frontal,parietal and temporal lobes.And there were involved parietal lobe in 13 cases(81.3%),occipital lobe in 12 cases(75.0%),frontal lobe in 9 cases(56.3%),temporal lobe in 5 cases(31.3%),and cerebellum in 4 caess(25.0%).Diffusion weighted imaging(DWI) was showed low to intermediate signal in 14 cases,and high intense signal in 2 cases.After expectant treatment,all the patients were cured.Conclusions The main clinical manifestation of RPLS are blood pressure elevation,headache,disordered vision,consciousness disorders and epilepsy.MRI is showed that ymmetric or asymmetric low signal on T1WI and high signal on T2WI in bilateral occipital lobule and/or frontal,parietal and temporal lobes.The prognosis is good after treatment.