子癇患者的脑部磁共振改变

目的：探讨子癇患者的脑部MRI改变。方法：回顾性分析16例子患者的脑部MRI资料,总结其特点。结果：16例患者均表现为大脑半球皮质、皮质下白质多发病灶,T1WI低信号、T2WI、Flair高信号,DWI等或高信号、表观弥散系数（ADC）图高信号,大部分呈对称分布。其中2例ADC图显示在高信号范围内夹杂局限性低信号改变;2例患者在病灶中央区合并局灶性T1WI稍低信号,T2WI、Flair低信号改变。受累部位以双侧枕、顶叶最常见,其次为基底节、额叶、颞叶,少数累及小脑半球、脑干。部分患者短期内复查MRI完全恢复正常。结论：血管源性脑水肿是子癇患者主要的影像学改变;少数患者可合并细胞毒性脑水肿或脑出血;病变最常见累及后循环,多呈可逆性。

The Changes of Brain MRI Imaging of Patients with Eclampsia

To explore the changes of brain MRI imaging of patients with eclampsia. Methods： Brain MRI results of 16 patients with eclampsia were analyzed retrospectively. Results： All of the 16 patients had multiple lesions in cortex and subcortex white matter with hypointensities on T1WI, hyperintensities on T2WI and FLAIR, hyperintensities or isointensities on DWI, and hyperintensities on ADC. Most lesions were distributed symmetrically. In 2 patients, hyperintensities on ADC showed mixed localized hypointense changes. Localized and slightly hypointense signals on T1WI and hypointensities on T2WI and Flair in the central area of the lesions were seen in 2 patients. Bilateral occipital lobes and parietal lobes were the most commonly affected areas, followed by basal ganglia, frontal lobes and temporal lobes. Cerebellar hemispheres and brain stem were affected in a few patients. Some patients were reexamined with MRI in a short period of time and the results were complete normal. Conclusion： Vasogenic brain edema is the main MRI changes in patients with eclampsia. Cytotoxic brain edema or cerebral hemorrhage may be also seen in a small number of patients. Posterior circulation is the most commonly affected and the pathological changes are usually reversible.