可逆性胼胝体压部病变综合征的临床与MRI表现

发布时间：2018-02-20 04:12

本文关键词： 可逆性胼胝体压部脑炎磁共振成像　出处：《临床放射学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨可逆性胼胝体压部病变综合征(RESLES)患者的临床和MRI表现。方法回顾性分析26例RESLES患者的临床资料和MRI影像表现特点。结果本组患者中,男20例,女6例,年龄3~38岁,中位年龄20.5岁,其中21例为发热起病,伴头痛15例,呕吐8例,咽喉痛3例,咳嗽3例,头晕5例,神志异常5例,言语不清4例,抽搐2例,步态不稳2例,深昏迷3例;5例无前驱感染症状,其中癫痫发作2例,多动症1例,双侧颊部痛1例,肢体麻木1例。早期MRI表现为胼胝体压部孤立性病变,多为圆形或椭圆形,T_1WI呈等信号或稍低信号,T_2WI呈稍高信号,FLAIR为稍高信号,DWI呈明显高信号,ADC呈低信号,边界尚清,无水肿及占位效应,增强扫描无强化。随访发现24例患者临床症状完全消失,2例预后不良。复查MRI显示所有胼胝体压部病灶消失,1例双侧脑桥出现异常信号。结论RESLES患者MRI表现为具有特异性的胼胝体压部孤立性可逆性病变,结合其前驱感染症状等临床特点,有利于其早期诊断及鉴别诊断,为临床诊治提供重要的参考依据。
[Abstract]:Objective to investigate the clinical and MRI features of patients with reversible corpus callosum disease syndrome (RS les). Methods the clinical data and MRI imaging features of 26 patients with RESLES were retrospectively analyzed. Results there were 20 males and 6 females, aged 3 to 38 years, in this group. The median age was 20.5 years old. Among them, 21 cases were fever, 15 cases of headache, 8 cases of vomiting, 3 cases of sore throat, 3 cases of cough, 5 cases of dizziness, 5 cases of abnormal mind, 4 cases of speech confusion, 2 cases of convulsion and 2 cases of unsteady gait. In 3 cases of deep coma, 5 cases had no symptoms of preemptive infection, 2 cases of epilepsy, 1 case of hyperactivity disorder, 1 case of bilateral buccal pain, 1 case of limb numbness, and 1 case of early MRI showed solitary lesion of corpus callosum. Most of them were round or oval T 1WI with equal signal intensity or slightly low signal intensity on T 2WI. Flair showed obvious high signal intensity on DWI and low signal intensity on DWI. The boundary was clear and there was no edema and space occupying effect. The clinical symptoms of 24 cases were completely disappeared and 2 cases had poor prognosis. MRI showed that all lesions of corpus callosum disappeared in 1 case with abnormal signal of bilateral pons. Conclusion the MRI findings of 24 cases with RESLES are positive. Specific solitary reversible lesions of the corpus callosum, Combined with the clinical characteristics of its precursor infection symptoms, it is beneficial to its early diagnosis and differential diagnosis, and provides an important reference for clinical diagnosis and treatment.
【作者单位】：南昌大学第一附属医院影像科;南昌大学第一附属医院神经内科;
【基金】：国家自然科学基金资助项目(编号:81260217,81460263)
【分类号】：R445.2;R741

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