可逆性后部白质脑病综合征的临床和影像学特点

发布时间：2018-04-30 10:05

本文选题：可逆性后部白质脑病综合征 + 磁共振成像　；参考：《中国卒中杂志》2016年03期

【摘要】：目的探讨可逆性后部白质脑病综合征(reversible posterior leukoencephalopathy syndrome,RPLES)的临床和影像学特点。方法回顾性分析中国人民解放军第306医院4例RPLES的临床症状及影像学特点。结果本组病例病因包括肾功能不全,高血压病,妊娠子痫,腰椎手术后。所有病例均有癫痫大发作及头痛,恶心呕吐,精神行为异常。其中肢体瘫痪1例,失语1例,癫痫持续状态1例。影像学表现为单侧或双侧以顶枕叶为主白质及灰质病变,病变范围可累及额颞叶。磁共振成像(magnetic resonance imaging,MRI)表观弥散系数(apparent diffusion coefficient,ADC)、T_2加权像、平扫液体衰减反转恢复序列(fluid attenuated inversion recovery,FLAIR)均呈高信号,T_1加权像呈略长信号,1例磁敏感成像上呈微出血。结论头痛和癫痫发作是RPLES的主要临床症状,多种病因可引起RPLES,影像学改变以皮质及皮质下水肿为主。
[Abstract]:Objective to investigate the clinical and imaging features of reversible posterior leukoencephalopathy syndrome (RPLESs). Methods the clinical symptoms and imaging features of 4 cases of RPLES in 306 Chinese PLA Hospital were retrospectively analyzed. Results the causes included renal insufficiency, hypertension, eclampsia during pregnancy and after lumbar surgery. All cases had seizures and headache, nausea and vomiting, abnormal mental behavior. There were 1 case of limb paralysis, 1 case of aphasia and 1 case of epileptic status. The imaging findings were unilateral or bilateral parietal occipital white matter and gray matter lesions, which could involve frontotemporal lobe. The apparent diffusion coefficients of magnetic resonance imaging (resonance) were as follows: (1) the apparent diffusion coefficient of magnetic resonance imaging (Mr) was appending parent diffusion coefficient (ADCC) / T _ 2 weighted image, and the fluid attenuation inversion recovery sequence (fluid attenuated inversion recovery sequence) was high signal T _ (1) weighted image with slightly longer signal in one case with microhemorrhage on magnetic sensitivity imaging. Conclusion headache and epileptic seizure are the main clinical symptoms of RPLES. RPLESs can be caused by many causes. The imaging changes are mainly cortical and subcortical edema.
【作者单位】：中国人民解放军第306医院神经内科;中国人民解放军第306医院磁共振室;中国人民解放军第306医院妇产科;中国人民解放军第306医院骨科;
【分类号】：R741

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