CAJ | 학술논문

目的分析我国老年人可逆性后部白质脑病综合征(reversible posterior leukoencephalopathy syndrome,RPLS)患者的临床表现和影像学特点.方法回顾报告5例老年RPLS患者的临床表现和影像学特点. 结果本组老年男性患者1例,女性4例,平均年龄(63.0±2.4)岁,5例患者均在起病时并存高血压.最常见的临床表现依次为视觉障碍5例,头痛4例,癫痫4例,意识障碍3例,病理反射2例,偏瘫2例.CT检查示4例患者表现异常,MRI检查示5例患者均出现枕叶病变,颞叶受累2例,顶叶受累1例.4例患者出院平均(48.8±29.2)d后CT检查为阴性结果,死亡1例.结论 RPLS是典型的多因共果疾病,血管原性假说被影像学研究结果证实.神经影像学对诊断RPLS很重要,弥散加权像(DWI)有助于鉴别诊断RPLS和缺血性脑血管病.
목적 분석아국노년인가역성후부백질뇌병종합정(reversible posterior leukoencephalopathy syndrome,RPLS)환자적림상표현화영상학특점.방법 회고보고5례노년RPLS환자적림상표현화영상학특점. 결과 본조노년남성환자1례,녀성4례,평균년령(63.0±2.4)세,5례환자균재기병시병존고혈압.최상견적림상표현의차위시각장애5례,두통4례,전간4례,의식장애3례,병리반사2례,편탄2례.CT검사시4례환자표현이상,MRI검사시5례환자균출현침협병변,섭협수루2례,정협수루1례.4례환자출원평균(48.8±29.2)d후CT검사위음성결과,사망1례.결론 RPLS시전형적다인공과질병,혈관원성가설피영상학연구결과증실.신경영상학대진단RPLS흔중요,미산가권상(DWI)유조우감별진단RPLS화결혈성뇌혈관병.
Objective To investigate the clinical and neuroimage characteristics of reversible posterior leukoencephalopathy syndrome (RPLS) in Chinese elderly patients. Methods The characteristic clinical presentation and neuroimaging of 5 elderly patients with RPLS were retrospectively analyzed. Results There were one male and four females in this study, with the average age of (63.0±2.4) years, all combined with hypertension. The most common clinical presentations were abnormality of visual perception (5 cases), headache (4 cases), epileptic seizure (4 cases), disturbance of consciousness (3 cases), pathological reflex (2 cases) and hemiplegia (2 cases). CT scan showed 4 cases with low density lesions. MR1 scan showed 5 cases with occipital lobe lesions, 2 with parietal lobe lesions and 1 with temporal lobe lesions. Re-examination of CT scans showed that 4 survived patients became normal at mean (48.8±29.2) days after discharging from hospital. Conclusions The etiologies of RPLS are diverse. The vasogenic theory is supported by neuroimage of RPLS. Neuroimage may be very important for the diagnosis of RPLS. Diffusion-weighted imaging and apparent diffusion coefficient map may be helpful for differential diagnosis between RPLS and cerebral infarct.