21例脑后部可逆性脑病综合征的临床和影像学特征分析

目的探讨脑后部可逆性脑病综合征(PRES)的临床和影像特征。方法回顾性分析21例PRES在发病机制、临床表现、病变部位、影像表现及疾病转归等方面的特点。结果病变主要分布在双侧顶枕皮质或皮质下白质区,以白质受累为主,可累及胼胝体、脑干、小脑及额颞叶等。扩散加权成像(DWI)PRES常为等高信号,表观扩散系数(ADC)表现为高信号。PRES一般是可逆的,部分可合并脑梗死或出血。结论 PRES的临床和影像学表现具有一定特征性,结合病史,采用多种影像学检查及随访有助于对PRES的正确诊断。

Analysis of clinical and imaging characteristics in posterior reversible encephalopathy syndrome in 21 cases

Objective To investigate clinical and imaging characteristics in posterior reversible encephalopathy syndrome(PRES).Methods Pathogenesy,clinical manifestation,diseased region,image manifestation and prognosis of 21 PRES cases were retrospectively analyzed.Results The lesions mainly located in cortex or subcortical white matter of bilateral posterior parietal and occipital lobe in all cases,randomly located in corpus callosum,brain stem,cerebellum,frontal and temporal lobe.These lesions dominantly located in subcortical white matter.Lesions appeared as normal or increased intensity on diffusion weighted imaging(DWI),and hyperintensity on apparent diffusion coefficient(ADC) maps.The lesions of PRES were reversible,some of cases may be accompanied with cerebral infarction or hemorrhage.Conclusion PRES represents characteristic clinical and image features.When combined with medical record,various image examination and follow-up,it is helpful for diagnosis of PRES correctly.