可逆性后部脑病综合征的临床及影像学表现

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1、可逆性后部脑病综合征的临床及影像学表现周小燕马隆佰韩武(广丙壮族自治区人民医院放射科CT、MRI室广丙南宁530021)【摘要】目的探宄可逆性后部脑病综合征(RPES)的影像学和临床表现。方法入选我院符合标准的患者54例，均给予MRI扫描，分析患者的影像学检查和临床表现特点。结果患者临床常见的症状主要为意识障碍、头痛、视觉障碍、恶心、发作性癫痫等，发病时常伴随血压升高，影像学表现为病灶主要分布在双侧大脑的后部皮层下白质区，经常可累及额叶、颞叶、脑干、小脑等。CT检查表现出低密度影，MRI检查表现出T1或长T2信号，18例行增强MR扫

2、描后，16例无强化，2例患者出现不同程度的增强；MRA检查没有发现血管的异常，1例患者表现大脑双侧中动脉的走形僵直。患者经临床治疗后例39病症完全消失，10例病变明显的缩小，5例遗留坏死的软化改变。结论可逆性后部脑病综合征患者采用MRI检查，详细准确的显示山患者的病灶部位，影像学和临床表现具有一定的特点，有利于临床上正确诊断和治疗疾病，特点显著，值得推广。【关键词】影像学表现可逆性后部脑病综合征临床表现【中图分类号】R445【文献标识码】A【文章编号】2095-1752(2014)14-0086-02TheClinicalandIm

3、agingFeaturesofPosteriorReversibleEncephalopathySyndrome(PRES)ZHOUXiao-yan,MALong-bai,HANwu(DepartmentofRadiology,CT/MRIRoom,thePeople’sHospitalofGuangxiZhuangAutonomousRegion,Nanning530021,China)【Abstract】Objective:Toexploretheclinicalandimagingfeaturesofposteri

4、orreversibleencephalopathysyndrome(PRES).Method:54patientsmetthestandardinourhospitalweregivenMRIscanning,analysisofthepatient'simagingcharacteristicsandclinicalmanifestations.Result:Thecommonclinicalsymptomsofpatientsweredisturbanceofconsciousness,headache,visualdisor

5、der,nausea,epilepsyandsoon.Morbidityassociatedwithelevatedbloodpressure.Imagingshowedfocuswasmainlydistributedintheposteriorsubcorticalwhitematterregionsofbothhemispheresofthebrainlikefrontallobe,temporallobe,cerebellum,brainstemandsoon.CTshowedlowdensity,MRIshowedT1an

6、dlongT2signal.AfterenhancedMRIscansin18cases,16casesshowednoenhancement,2patientshaddifferentenhancement.MRAexaminationfoundnovascularanomalies,1patientsshowedthemiddlecerebralarteryofbilateralcerebraldeformationrigidity.Patientsafterclinicaltreatment,symptomsdisappear

7、edcompletelyin39,10casesoflesionsreducedsignificantly,5casesleftnecrosissofteningchange.Conclusion:PREStreatedbyMRIexaminationshowlesionsdetailedandaccurate.Beneficialtotheclinicaldiagnosisandtreatmentofdisease.Thecurativeeffectisremarkable,isworthpromotingtheapplicati

8、on.【Keywords】ImagingFeaturesPRESClinicalManifestation可逆性后部脑病综合征(RPES)在临床上是一种具有破坏性的神经性疾病,由于过去医学设备的简陋和缺乏，对此病的特点及临床表现没奋全