中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
18期
29-31
,共3页
产后期%脑疾病%磁共振成像%脑后部可逆性脑病综合征
產後期%腦疾病%磁共振成像%腦後部可逆性腦病綜閤徵
산후기%뇌질병%자공진성상%뇌후부가역성뇌병종합정
Postpartum period%Brain diseases%Magnetic resonance imaging%Posterior reversible encephalopathy syndrome
目的 探讨孕妇产后脑后部可逆性脑病综合征(PRES)的MRI影像学特点.方法 回顾性分析8例孕妇产后PRES患者的临床及影像学资料,其中5例为产后1周内发生,2例为产后2周发生,1例为产后4周发生.8例患者均行MRI检查,检查序列包括T1WI、T2WI、FLAIR、弥散加权像(DWI)、磁敏感序列(SWX),其中4例患者行磁共振静脉成像(MRV).结果 8例患者MRI显示脑内病变均呈对称性分布,好发于大脑后部顶枕叶,额叶亦常受累,其他相对少见的病变范围包括脑干、小脑及基底节区等,病变于T1WI呈等或低信号,T2WI及FLAIR呈高信号,部分病灶DWI表现为高信号.其中双侧顶叶8例、双侧枕叶8例、双侧额叶4例、双侧颞叶6例、双侧颞枕叶交界区8例、胼胝体压部1例、双侧基底节区1例、双侧半卵圆中心1例、双侧小脑半球1例,左侧额叶脑出血1例.5例随访MRI显示病灶范围和数目明显变小、减少、消失.结论 MRI可以对孕妇产后PRES做出明确诊断,从而进一步指导临床治疗及预防并发症.
目的 探討孕婦產後腦後部可逆性腦病綜閤徵(PRES)的MRI影像學特點.方法 迴顧性分析8例孕婦產後PRES患者的臨床及影像學資料,其中5例為產後1週內髮生,2例為產後2週髮生,1例為產後4週髮生.8例患者均行MRI檢查,檢查序列包括T1WI、T2WI、FLAIR、瀰散加權像(DWI)、磁敏感序列(SWX),其中4例患者行磁共振靜脈成像(MRV).結果 8例患者MRI顯示腦內病變均呈對稱性分佈,好髮于大腦後部頂枕葉,額葉亦常受纍,其他相對少見的病變範圍包括腦榦、小腦及基底節區等,病變于T1WI呈等或低信號,T2WI及FLAIR呈高信號,部分病竈DWI錶現為高信號.其中雙側頂葉8例、雙側枕葉8例、雙側額葉4例、雙側顳葉6例、雙側顳枕葉交界區8例、胼胝體壓部1例、雙側基底節區1例、雙側半卵圓中心1例、雙側小腦半毬1例,左側額葉腦齣血1例.5例隨訪MRI顯示病竈範圍和數目明顯變小、減少、消失.結論 MRI可以對孕婦產後PRES做齣明確診斷,從而進一步指導臨床治療及預防併髮癥.
목적 탐토잉부산후뇌후부가역성뇌병종합정(PRES)적MRI영상학특점.방법 회고성분석8례잉부산후PRES환자적림상급영상학자료,기중5례위산후1주내발생,2례위산후2주발생,1례위산후4주발생.8례환자균행MRI검사,검사서렬포괄T1WI、T2WI、FLAIR、미산가권상(DWI)、자민감서렬(SWX),기중4례환자행자공진정맥성상(MRV).결과 8례환자MRI현시뇌내병변균정대칭성분포,호발우대뇌후부정침협,액협역상수루,기타상대소견적병변범위포괄뇌간、소뇌급기저절구등,병변우T1WI정등혹저신호,T2WI급FLAIR정고신호,부분병조DWI표현위고신호.기중쌍측정협8례、쌍측침협8례、쌍측액협4례、쌍측섭협6례、쌍측섭침협교계구8례、변지체압부1례、쌍측기저절구1례、쌍측반란원중심1례、쌍측소뇌반구1례,좌측액협뇌출혈1례.5례수방MRI현시병조범위화수목명현변소、감소、소실.결론 MRI가이대잉부산후PRES주출명학진단,종이진일보지도림상치료급예방병발증.
Objective To investigate the MRI appearances of postpartum posterior reversible encephalopathy syndrome (PRES). Methods The clinical and radiological data of 8 patients with postpartum PRES were analyzed retrospectively, 5 cases were 1 week after postpartum,2 cases were 2 weeks afterpostpartum, 1 case was 4 weeks after postpartum. All cases underwent MRI examination, checking sequence included T,WI,T2WI,FLAIR,DWI,SWI, and 4 of them underwent MR venography (MRV). Results MRI showed basal bilaterally symmetrical distributions of lesions, mainly located in subcortex and cortex of cerebral hemisphere and predominantly in the occipital lobe,the lesions appeared as hyperintensity on FLAIR and T2WI,isointensity or mildly hypointensity on T1WI,hyperintensity on DWI. MRI in 8 patients demonstrated multiple lesions located in bilateral parietal lobe (8 cases),bilateral occipital lobe (8 cases), bilateral frontal lobe ( 4 cases ), bilateral temporal lobe (6 cases ), bilateral tempura-occipital lobe ( 8 cases),splenium of corpus callosum(l case), bilateral basal ganglia (l case), bilateral oval center( 1 case), bilateral cerebellar hemisphere (1 case), left frontal lobe hemorrhage (l case). Five patients' follow-up scan showed decreased or disappeared abnormal signals. Conclusion MRI examination scan identify the location, quality and degree, meanwhile, analyze the pathological foundation of postpartum PRES, which conduces to guiding treatment and preventing complication.
