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Posterior reversible encephalopathy syndrome: diagnosis with CT and MRI
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 9
- DOI:
- 10.3760/j.issn:1005-1201.2006.09.003
- Key Word:
- 脑疾病;顶叶;枕叶;磁共振成像;体层摄影术,X线计算机
Abstract： 目的 探讨CT、MRI在诊断脑后部可逆性脑病综合征(PRES)中的价值.方法 8例女性PRES患者中6例为孕妇,1例肺癌手术后化疗患者,1例高血压患者,均行MR静脉成像(MRV)、T1WI、T2WI、水抑制序列(FLAIR)成像及扩散加权成像(DWI);其中2例行CT平扫,5例行增强MRI及三维增强MR血管成像(3D CEMRA).结果 CT示病灶呈低密度,边界不清.8例患者MRV显示脑静脉、静脉窦通畅,无狭窄、异常扩张及血栓形成征象.MRI显示双侧顶枕叶(8例)、基底节区(2例)、额叶(4例)多发异常信号,主要位于双侧顶枕叶皮质下白质内,3例患者皮质亦受累.在T1WI病灶呈等或略低信号,T2WI及FLAIR呈高信号,以FLAIR像显示皮质病变为佳.DWI显示大部分病灶呈等信号,表观扩散系数(ADC)图呈等或高信号.部分病灶DWI及ADC图均表现为高信号.随访MRI显示所有患者病灶范围、数目逐渐变小、减少.5例行增强扫描患者显示病灶呈轻度强化,3D CEMRA显示强化沿双侧大脑前动脉、大脑中动脉及大脑后动脉终末支分布,部分呈"葡萄状".随访增强扫描显示病灶强化范围及程度逐渐缩小、消失.结论 FRES好发于顶枕叶白质,但也可见于基底节、额叶及脑皮质.病变为血管源性水肿,增强T1WI及3D CEMRA显示病灶有可逆性强化.以MR FLAIR及T2WI序列显示病灶最佳.
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