脑后部可逆性脑病综合征的影像学分析

目的探讨影像学在诊断脑后部可逆性脑病综合征(PRES)的应用价值。方法回顾分析41例临床诊断为PRES患者的影像学资料,其中15例接受CT检查,8例接受MRI检查,18例同时接受CT和MRI检查。结果 PRES累及双侧顶枕叶(27例)、基底节区(6例)、额叶(7例)、小脑半球(1例),主要位于双侧顶枕叶皮质下脑白质内,7例患者皮质亦受累。CT呈稍低密度影;MRI扫描T1WI呈等或略低信号,T2WI及液体衰减反转恢复(FLAIR)呈高信号,以FLAIR序列显示皮质病变为佳。DWI显示大部分病灶呈等或略高信号,表观扩散系数(ADC)图呈略高信号。随访所有患者病灶范围变小、数目逐渐减少。结论 PRES好发于顶枕叶白质,但也可见于基底节、额叶及脑皮质,MRI FLAIR及T2WI序列显示病灶较佳。CT、MRI头部扫描及定期复查对PRES的诊断和疗效评价具有重要意义。

Imaging Analysis of Posterior Reversible Encephalopathy Syndrome

Objective To evaluate the utility of imaging in diagnosis of posterior reversible encephalopathy syndrome(PRES).Methods Images of 41 patients with PRES were reviewed retrospective1y.Among these 41 patients,15 underwent CT scan,8 underwent MRI scan and 18 underwent both CT and MRI Scan.Results Lesions of PRES located in bilateral parieto-occipital lobes(27 cases),bilateral basal ganglias(6 cases),bilateral frontal lobes(7 cases),and cerebellar hemisphere(1 case).The lesions were prominent within white matter,some of them involved gray matter(7 cases).Lesions appeared as low density on CT images,isointense or mildly hypointense signals on T1-weighted images,hyperintense on FLAIR and T2-weighted images,normal or mildly hyperintensity on DWI,and mildly hyperintensity on apparent diffusion coefficient(ADC)images.The followed scan showed decreased abnormal signals.Conclusion Lesions of PRES are usually located in parieto-occipital lobes,especially in white matter,but they can also be seen in basal ganglia,frontal lobe,and gray matter.T2-weighted and FLAIR have advantages to display lesions in PRES.Cranial CT and MRI scan have great significance for the diagnosis and differential diagnosis of PRES as well as the assessment of therapeutic effect.