| 杨民正，胡玮，杨琨，梁萍.围产期脑后部可逆性脑病综合征的MRI诊断及预后评估价值.[J].中南医学科学杂志.,2012,40(2):171-174. |
| 围产期脑后部可逆性脑病综合征的MRI诊断及预后评估价值 |
| Diagnostic and Prognostic Value of MRI With Peripartum Posterior Reversible Encephalopathy Syndrome |
| 投稿时间：2011-09-02 |
| DOI： |
| 中文关键词: 脑疾病 脑后部可逆性脑病综合征 磁共振成像 扩散加权成像 |
| 英文关键词:brain diseases posterior reversible encephalopathy syndrome magnetic resonance imaging diffusion-weighted imaging |
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| 中文摘要: |
| 目的探讨围产期脑后部可逆性脑病综合征（PRES）的MRI诊断及预后评估价值。方法回顾性分析本院13例围产期脑后部可逆性脑病综合征的临床和MRI资料，并进行随访追踪。13例病例均行T1WI、T2WI、FLAIR序列及扩散加权成像（DWI），其中7例行增强MRI，5例行MR静脉成像（MRV）。结果全部病例均急性起病，均有血压骤然升高病史。MRI表现为双侧对称性以大脑后部皮质下白质为主的病变，包括颞叶、额叶、基底节、小脑、脑干等亦可受累，T1WI呈等或低信号，T2WI呈高信号，FLAIR呈高信号，DWI呈等信号8例，稍高信号4例，ADC图呈稍高信号，有1例DWI呈高信号，ADC图呈略低信号。治疗后随访MRI显示DWI呈等或稍高信号、ADC图呈稍高信号者预后良好，DWI呈高信号、ADC图呈略低信号者预后欠佳。结论围产期PRES具有特征性的MRI表现，病变为血管源性水肿，治疗及时可逆转。MRI应作为本病的首选检查方法，DWI对预后评估具有重要价值。 |
| 英文摘要: |
| ObjectiveTo investigate the diagnostic and prognostic value of MRI with peripartum posterior reversible encephalopathy syndrome.Methods13 cases with peripartum PRES with MRI data were retrospectively reviewed and followed up.All of them had MRI imaging routinely (T1WI,T2WI,FLAIR,DWI)，and 7 cases underwent post-contrast T1WI，5 had MRV.ResultsThe disease in all patients developed acutely，and they presented sudden rise of blood pressure.The most common abnormality on MRI was edema predominantly involving the cortex and subcortical white matter in the posterior portions of cerebral hemispheres，including emporal lobes,frontal lobes，basal ganglia，cerebellum and brain stem.Lesions appeared as high signal on FLAIR and T2WI，isointensity or low signal on T1WI，no signal changes in 8 cases，mild high signal in 4 cases on DWI and ADC maps，on the other hand，1 case showed high signal on DWI and mild low signal on ADC maps.After aggressive treatment and followed-up，it showed that patients who had isointensity or mild high signal on DWI and ADC maps had better prognosis，and those who had high signal on DWI and mild low signal on ADC maps had poor prognosis.ConclusionThe imaging findings of peripartum PRES are typical.It shows vasogenic edema and can be reversed by proper treatment.MRI should be the first choice in its diagnosis.Diffusion-weighted imaging for judging the prognosis has important clinical value. |
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