可逆性后部脑病综合征的CT和MRI诊断

目的 探讨可逆性后部脑病综合征(RPES)的CT和MRI特点.方法回顾性分析5例经临床随访证实的RPES患者的临床和MRI资料.结果 头颅MRI检查显示病变累及双侧枕叶4例,双侧顶叶及双侧基底节对称性受累各2例,2例单侧顶叶受累,1例伴胼胝体压部受累,1例左侧小脑受累.MRI信号呈T_1WI低信号,T_2WI高信号,FLAIR序列病灶信号明显增高,增强扫描病灶无明显强化.5例弥散加权成像随着b值的加大(0,500,1000 s/mm2),病灶高信号逐渐减低,ADC信号略增高.CT扫描病灶呈低密度影.结论 MRI表现结合临床资料,可正确诊断可逆性后部脑病综合征.

CT and MRI Diagnosis of Reversible Posterior Encephalopathy Syndrome

Objective To investigate CT and MRI characteristics of reversible posterior encephalopathy syndrome (RPES).Methods The clinical and imaging data of 5 patients with RPES confirmed by clinical follow-up were analyzed retrospectively.Results Among the 5 cases ,brain MRI showed that bilateral occipital lobe involved symmetrically in 4 cases ,parietal lobe involved symmetrically in 2 cases,bilateral basal nucleus involved symmetrically in 2 cases,one sided parietal lobe involved in 2 cases,corpus callosum involved in 1 case and cerebellum involved in 1 case. The lesions were low signal on T_1WI,high signal on T_2WI and FLAIR, no enhancement was showed after contrast-enhanced scan. The signal intensity of the lesions was decreased gradually with the b value increased(0,500,1000) at DWI and apparent diffusion coefficient(ADC) slightly increased.The lesions revealed low density on CT images.Conclusion MRI in combination with clinical informations can exactly diagnose RPES.