可逆性后部白质脑病综合征相关临床及影像学特征

发布时间：2018-02-17 06:24

本文关键词： 可逆性后部白质脑病综合征临床特征影像学特征　出处：《重庆医科大学学报》2017年06期 　论文类型：期刊论文

【摘要】：目的:探讨脑后部可逆性脑病综合征(posterior reversible encephalopathy syndrome,PRES)的临床及影像学特征,并进一步分析该病临床与影像学特征间的关联,以期阐明其发病机制。方法:连续入组2007年5月1日至2016年12月1日在重庆医科大学附属第一医院住院的23名PRES患者,对其病历资料进行回顾性分析。结果:共识别23名PRES患者(男性4例,女性19例),平均年龄(32.96±15.10)岁,分别见于高血压、子痫或先兆子痫、应用免疫抑制剂、肝硬化、肾功能不全及自身免疫性疾病患者。最常见的症状是头痛(n=18,78.2%)和痫性发作(n=16,69.6%)。在21名接受磁共振成像(magnetic resonance imaging,MRI)检查的患者中,除典型的顶枕叶受累外,额叶、基底节区、颞叶、脑干、小脑等不典型部位受累也常见,且有1/3的患者其病灶非完全对称分布。另外,痫性发作的患者颞叶更易受累;合并自身免疫性疾病的患者小脑更易受累。结论:PRES的不典型表现多见,临床工作者需全面掌握其临床和影像学特征及两者间的关联,方能对该病进行准确的诊断及治疗。
[Abstract]:Objective: to investigate the clinical and imaging features of posterior reversible encephalopathy syndrome (PRESs) in the posterior part of the brain, and to analyze the relationship between the clinical and imaging features of the disease. Methods: from May 1st 2007 to December 1st 2016, 23 PRES patients were hospitalized in the first affiliated Hospital of Chongqing Medical University. Results: a total of 23 PRES patients (male 4, female 19) with an average age of 32.96 卤15.10 years were identified as having hypertension, eclampsia or preeclampsia, immunosuppressive agents and cirrhosis. Patients with renal insufficiency and autoimmune diseases. The most common symptoms are headache 1878.2) and epileptic seizures 1669.60.Among the 21 patients undergoing magnetic resonance imaging, the frontal lobe, basal ganglia, temporal lobe, brain stem, in addition to typical occipital lobe involvement, The involvement of atypical sites such as cerebellum was also common, and 1/3 of the patients had incomplete distribution of lesions. In addition, the temporal lobe of patients with epileptic seizures was more likely to be involved. Conclusion the atypical manifestations of the cerebellum in the patients with autoimmune diseases are more common. The clinical and imaging features and the correlation between the two should be fully mastered in order to accurately diagnose and treat the disease.
【作者单位】：重庆医科大学附属第一医院神经内科;重庆医科大学附属第一医院放射科;
【分类号】：R742

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