CAJ | 학술논문

目的：分析并对比产褥期脑后部可逆性脑病综合征、静脉窦栓塞、脑梗塞、脑炎的临床及MRI影像学表现，探讨 MRI 特定序列在产妇神经系统疾病的鉴别诊断、治疗和预后评估中的价值。方法回顾性分析35例产褥期神经系统疾病患者的临床及 MRI 资料。35例患者均行 MRI 检查，检查序列包括：T1WI、T2WI、FLAIR/T2WI、DWI、ADC 值的测定及 MRV。比较不同疾病的临床表现，并分析其颅内病灶的信号特征，评价MRI不同序列在鉴别诊断及治疗评估中的作用。结果 PRES颅内病灶具有多发性、对称性，多示为T1WI低信号、T2WI高信号、DWI高信号、ADC值减低；CVST颅内病灶与其引流的静脉窦血栓形成部位相一致，多示为T1WI低信号、T2WI高信号，合并出血时夹杂点片样T1WI高信号，DWI低信号、ADC值增高；脑梗塞颅内病灶与相应动脉分布区相一致，多示为T1WI低信号、T2WI高信号、DWI低信号、ADC值增高；脑炎颅内病灶具有多发性，多示为T1WI低信号、T2WI高信号、DWI低信号、ADC值增高。结论产后脑后部可逆性脑病综合征、脑梗塞、脑炎、静脉窦栓塞临床及影像学表现各有相似及不同之处，MRI 是首选影像诊断手段， FLAIR/T2WI序列可以提高病变的检出率，MRV、DWI及ADC值的测定对正确诊断和预后有重要价值。
목적：분석병대비산욕기뇌후부가역성뇌병종합정、정맥두전새、뇌경새、뇌염적림상급MRI영상학표현，탐토 MRI 특정서렬재산부신경계통질병적감별진단、치료화예후평고중적개치。방법회고성분석35례산욕기신경계통질병환자적림상급 MRI 자료。35례환자균행 MRI 검사，검사서렬포괄：T1WI、T2WI、FLAIR/T2WI、DWI、ADC 치적측정급 MRV。비교불동질병적림상표현，병분석기로내병조적신호특정，평개MRI불동서렬재감별진단급치료평고중적작용。결과 PRES로내병조구유다발성、대칭성，다시위T1WI저신호、T2WI고신호、DWI고신호、ADC치감저；CVST로내병조여기인류적정맥두혈전형성부위상일치，다시위T1WI저신호、T2WI고신호，합병출혈시협잡점편양T1WI고신호，DWI저신호、ADC치증고；뇌경새로내병조여상응동맥분포구상일치，다시위T1WI저신호、T2WI고신호、DWI저신호、ADC치증고；뇌염로내병조구유다발성，다시위T1WI저신호、T2WI고신호、DWI저신호、ADC치증고。결론산후뇌후부가역성뇌병종합정、뇌경새、뇌염、정맥두전새림상급영상학표현각유상사급불동지처，MRI 시수선영상진단수단， FLAIR/T2WI서렬가이제고병변적검출솔，MRV、DWI급ADC치적측정대정학진단화예후유중요개치。
Objective: To analyze and contrast the clinical and imaging findings and explore the value of specific sequences of magnetic resonance imaging(MRI)in the diagnosis and cure of parturient with posterior reversible encephalopathy syndrome (PRES), cerebral venous-sinus thrombosis (CVST), cerebral infarction (CI) and encephalitis. Methods: The clinical and MRI imaging data of 35 patients with central nervous system disease were retrospectively studied. All of the patients received MRI examination with the sequences of T1WI, T2WI, FLAIR/T2WI, DWI, ADC and MRV. The clinical features and the characteristic signals of cerebral lesions were analyzed and compared, and the values of MRI different sequences in the diagnosis and treatment were evaluated. Results: The encephalic niduses of PRES were multifocal, symmetry, and showed low T1WI signal, high T2WI and DWI signal, and lowing ADC map. The position of encephalic niduses of CVST was in agreement with its drainaged venous sinus thrombosis with low T1WI and high T2WI signal, and they may be mingled with high T1WI and low DWI signal, increasing ADC map, if they were of bleeding. The position of encephalic niduses of CI was found in agreement with the corresponding artery distribution area with low T1WI and DWI signal, high T2WI signal and ADC map. The encephalic niduses of encephalitis were multifocal and showed low T1WI and DWI signal, high T2WI signal and increasing ADC map. Conclusions:There are similarity and difference in the clinical and imaging findings of PRES, CVST, CI and encephalitis. MRI is the first choice of the diagnosis, FLAIR/T2WI could increase the detection rates of the lesion, MRV, DWI, ADC examination are important in the correct diagnosis and prognosis.