中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2008年
19期
20-23
,共4页
脑白质病%体层摄影术,X线计算机%磁共振成像
腦白質病%體層攝影術,X線計算機%磁共振成像
뇌백질병%체층섭영술,X선계산궤%자공진성상
Leukoencephalopathy%Tomography,X-ray computed%Magnetic resonance imaging
目的 探讨可逆性后部白质脑病综合征(RPLS)影像学与临床特点.方法 回顾性分析2004年6月至2007年10月6例RPLS患者的影像学及临床资料.结果 6例均行MRI及CT检查,4例双侧对称性枕叶白质受累,4例双侧额顶叶皮质下白质广泛受累,1例同时累及中脑和丘脑,1例累及尾状核头部;病灶形态不规则,表现为皮质及皮质下白质脑回样异常信号,2例妊娠高血压综合征磁共振静脉造影显示未发现静脉窦血栓形成.所有患者均给予积极治疗原发病、控制血压、控制癫痫发作、脱水减轻脑水肿及对症支持治疗.5例患者症状基本消失,1例遗留右侧肢体轻偏瘫.无一例死亡.结论 只要结合临床病史,特别是具有高血压、子痫及肾功能不全的患者出现典型的临床四联征,影像学为后部脑白质损害为主的表现,RPLS的诊断并不困难.
目的 探討可逆性後部白質腦病綜閤徵(RPLS)影像學與臨床特點.方法 迴顧性分析2004年6月至2007年10月6例RPLS患者的影像學及臨床資料.結果 6例均行MRI及CT檢查,4例雙側對稱性枕葉白質受纍,4例雙側額頂葉皮質下白質廣汎受纍,1例同時纍及中腦和丘腦,1例纍及尾狀覈頭部;病竈形態不規則,錶現為皮質及皮質下白質腦迴樣異常信號,2例妊娠高血壓綜閤徵磁共振靜脈造影顯示未髮現靜脈竇血栓形成.所有患者均給予積極治療原髮病、控製血壓、控製癲癇髮作、脫水減輕腦水腫及對癥支持治療.5例患者癥狀基本消失,1例遺留右側肢體輕偏癱.無一例死亡.結論 隻要結閤臨床病史,特彆是具有高血壓、子癇及腎功能不全的患者齣現典型的臨床四聯徵,影像學為後部腦白質損害為主的錶現,RPLS的診斷併不睏難.
목적 탐토가역성후부백질뇌병종합정(RPLS)영상학여림상특점.방법 회고성분석2004년6월지2007년10월6례RPLS환자적영상학급림상자료.결과 6례균행MRI급CT검사,4례쌍측대칭성침협백질수루,4례쌍측액정협피질하백질엄범수루,1례동시루급중뇌화구뇌,1례루급미상핵두부;병조형태불규칙,표현위피질급피질하백질뇌회양이상신호,2례임신고혈압종합정자공진정맥조영현시미발현정맥두혈전형성.소유환자균급여적겁치료원발병、공제혈압、공제전간발작、탈수감경뇌수종급대증지지치료.5례환자증상기본소실,1례유류우측지체경편탄.무일례사망.결론 지요결합림상병사,특별시구유고혈압、자간급신공능불전적환자출현전형적림상사련정,영상학위후부뇌백질손해위주적표현,RPLS적진단병불곤난.
Objective To investigate the imaging and clinical characteristics of reversible posterior leukoencephalopathy syndrome (RPLS). Method The imaging and clinical data of 6 patients with RPLS were analyzed retrospectively. Results CT and MRI examination in 6 patients revealed symmetry white matter lesions of occipital lobe in 4 patients, widely white matter edema of fronto-parietal subcortieal white matter in 4 patients, mesencephal and thalamencephal involved in 1 patient, caudate nucleus involved in 1patient. Venous sinus thrombosis was not found in 2 patients of pregnancy-induced hypertension syndrome with magnetic resonance intravenous angiography.All patients were given active treatment,including controlling blood pressure and seizure disorder,dehydration and supporting therapy.The symptom of 5 patients disappeared. One patient left with hemiparesis of right body.Nobody died. Condusion Diagnosis of RPLS isn't difficult as long as clinical history,imaging characteristics and clinical tetrad in the patients of hyperten-sion,eclamptism or renal inadequacy is combined to consider.
