急性高山病致可逆性胼胝体病变综合征的临床和MRI表现

发布时间：2018-09-12 21:11

【摘要】：目的探讨急性高山病(AMS)所致可逆性胼胝体病变综合征(RESLES)患者的临床特征和影像学演变特点。方法对5例AMS患者的临床及治疗前、后的MRI资料进行回顾性分析。结果 5例中,3例伴有高原性肺水肿(HAPE),均有视乳头充血或水肿,其中血常规检查2例显示白细胞和嗜中性粒细胞百分比明显升高。治疗前5例头颅MRI均表现为胼胝体压部椭圆形、边界清楚的异常信号,T1WI呈稍低信号,T2WI呈稍高信号,液体衰减反转恢复(Flair)呈高信号,扩散加权成像(DWI)呈显著高信号,相应表观扩散系数(ADC)呈显著低信号;其中1例严重高原性脑水肿(HACE)患者胼胝体膝部、体部和深部白质区还可见对称性类似信号。治疗后所有患者临床症状消失,复查MRI显示原有病灶完全消失。结论 AMS所致RESLES的临床及和MRI表现有一定特征性,其病理生理机制还需要进一步的探究。
[Abstract]:Objective to investigate the clinical and imaging features of reversible corpus callosum syndrome (RESLES) caused by acute alpine disease (AMS). Methods the MRI data of 5 patients with AMS before and after treatment were analyzed retrospectively. Results among the 5 cases, 3 cases with high altitude pulmonary edema (HAPE),) had hyperemia or edema of optic papilla, among which 2 cases showed increased percentage of leukocytes and neutrophils by blood routine examination. Before treatment, 5 cases of MRI showed oval shape of corpus callosum, slightly low signal intensity on T 1WI, high signal intensity on T 2WI, high signal intensity on fluid attenuated inversion recovery (Flair), and significant high signal intensity on diffusion weighted imaging (DWI). The corresponding apparent diffusion coefficient (ADC) showed a significant low signal intensity, in which a case with severe high altitude cerebral edema (HACE) showed similar symmetrical signals in the genu of corpus callosum, body and deep white matter. After treatment, all the clinical symptoms disappeared, and MRI showed that the original lesions disappeared completely. Conclusion the clinical and MRI manifestations of RESLES induced by AMS have some characteristics, and the pathophysiological mechanisms need to be further explored.
【作者单位】：西藏军区总医院CT、MR室;西藏军区总医院神经内科;第三军医大学第一附属医院放射科;
【分类号】：R445.2;R742

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