可逆性脑后部白质病变综合征影像学特点分析
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摘要
目的探讨可逆性脑后部白质病变综合征的影像学特点。方法回顾性分析11例可逆性脑后部白质病变综合征患者的影像学资料。结果患者中累及枕叶9例,顶叶8例,额叶8例,基底节6例,颞叶2例,胼胝体1例和小脑1例。CT平扫示枕叶、顶叶、额叶、基底节、颞叶、胼胝体和小脑等低密度。MRI平扫示T_1WI为低信号、T_2WI及Flair为高信号。DWI可呈等或稍高信号,ADC可呈等、稍高、高或低信号。结论可逆性脑后部白质病变综合征可累及部位主要局限于顶枕叶,但额叶、基底节、颞叶、胼胝体及小脑等部位亦可受累。Flair、DWI和ADC序列对病变最为敏感。
Objective To explore the radiological features of reversible posterior leukoencephalopathy syndrome(RPLS). Methods The neuroimage data of 11 RPLS patients were retrospectively analyzed. Results The lesions involved occipital lobe in 9 patients,parietal lobes in 8 patients,frontal lobe in 8 patients,basal ganglia in 6 patients,temporal lobe in 2 patients,corpus callosum in 1 patient,and cerebellum in 1 patient. CT scan showed lowdensity in occipital lobe,parietal lobes,frontal lobe,basal ganglia,temporal lobe,corpus callosum and cerebellum.MRI scan showed low T_1WI signal,and increase in T_2WI signal. DWI showed isointense or slightly hyperintense,and ADC showed isointense,slightly hyperintense,hyperintense or hypointense signal. Conclusions The lesions in RPLS mainly cover parietal lobes and occipital lobe,however,the frontal lobe,basal ganglia,temporal lobe,corpus callosum and cerebellum can also be affected. The sequences of Flair,DWI and ADC are most sensitive to the lesions of RPLS.
Objective To explore the radiological features of reversible posterior leukoencephalopathy syndrome(RPLS). Methods The neuroimage data of 11 RPLS patients were retrospectively analyzed. Results The lesions involved occipital lobe in 9 patients,parietal lobes in 8 patients,frontal lobe in 8 patients,basal ganglia in 6 patients,temporal lobe in 2 patients,corpus callosum in 1 patient,and cerebellum in 1 patient. CT scan showed lowdensity in occipital lobe,parietal lobes,frontal lobe,basal ganglia,temporal lobe,corpus callosum and cerebellum.MRI scan showed low T_1WI signal,and increase in T_2WI signal. DWI showed isointense or slightly hyperintense,and ADC showed isointense,slightly hyperintense,hyperintense or hypointense signal. Conclusions The lesions in RPLS mainly cover parietal lobes and occipital lobe,however,the frontal lobe,basal ganglia,temporal lobe,corpus callosum and cerebellum can also be affected. The sequences of Flair,DWI and ADC are most sensitive to the lesions of RPLS.
引文
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[4]Siebert E,Bohner G,Endres M,et al.Clinical and radiological spectrum of posterior reversible encephalopathy syndrome:does age make a difference?A retrospective comparison between adult and pediatric patients[J].PLo S One,2014,9:e115073.
[5]Singh RR,Ozyilmaz N,Waller S,et al.A study on clinical and radiological features and outcome in patients with posterior reversible encephalopathy syndrome(PRES)[J].Eur J Pediatr,2014,173:1225.
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[7]Fugate JE,Rabinstein AA.Posterior reversible encephalopathy syndrome:clinical and radiological manifestations,pathophysiology,and outstanding questions[J].Lancet Neurol,2015,14:914.
[8]Marra A,Vargas M,Striano P,et al.Posterior reversible encephalopathy syndrome:The endothelial hypotheses[J].Med Hypotheses,2014,82:619.
[9]Kastrup O,Schlamann M,Moenninghoff C,et al.Posterior reversible encephalopathy syndrome:the spectrum of MR imaging patterns[J].Clin Neuroradiol,2015,25:161.
[10]Gao B,Lv C.Posterior reversible encephalopathy syndrome in 46 of47 patients with eclampsia:beyond it[J].Am J Obstet Gynecol,2014,211:83.
[2]韩顺昌,张辉,郭阳,等.可逆性后部白质脑病综合征的临床及影像学特点[J].临床神经病学杂志,2007,20:161.
[3]Rykken JB,Mckinney AM.Posterior reversible encephalopathy syndrome[J].Semin Ultrasound CT MR,2014,35:118.
[4]Siebert E,Bohner G,Endres M,et al.Clinical and radiological spectrum of posterior reversible encephalopathy syndrome:does age make a difference?A retrospective comparison between adult and pediatric patients[J].PLo S One,2014,9:e115073.
[5]Singh RR,Ozyilmaz N,Waller S,et al.A study on clinical and radiological features and outcome in patients with posterior reversible encephalopathy syndrome(PRES)[J].Eur J Pediatr,2014,173:1225.
[6]邸卫英,苏立凯,王德超,等.可逆性后部白质脑病综合征的临床及影像学特点[J].临床神经病学杂志,2012,25:308.
[7]Fugate JE,Rabinstein AA.Posterior reversible encephalopathy syndrome:clinical and radiological manifestations,pathophysiology,and outstanding questions[J].Lancet Neurol,2015,14:914.
[8]Marra A,Vargas M,Striano P,et al.Posterior reversible encephalopathy syndrome:The endothelial hypotheses[J].Med Hypotheses,2014,82:619.
[9]Kastrup O,Schlamann M,Moenninghoff C,et al.Posterior reversible encephalopathy syndrome:the spectrum of MR imaging patterns[J].Clin Neuroradiol,2015,25:161.
[10]Gao B,Lv C.Posterior reversible encephalopathy syndrome in 46 of47 patients with eclampsia:beyond it[J].Am J Obstet Gynecol,2014,211:83.