可逆性后部白质脑病综合症的临床和影像学分析

›› 2009, Vol. 4 ›› Issue (02): 109-112.

可逆性后部白质脑病综合症的临床和影像学分析

张在强，牛松涛，翦凡，于学英，邵晓秋

首都医科大学附属北京天坛医院神经内科

收稿日期:2008-12-12 修回日期:1900-01-01 出版日期:2009-02-20 发布日期:2009-02-20
通讯作者: 张在强

Clinical and Neuroimaging Characteristics of Reversible Posterior Leukoencephalopathy Syndrome

ZHANG Zai-Qiang, Niu Song-Tao, JIAN Fan, et al.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China

Received:2008-12-12 Revised:1900-01-01 Online:2009-02-20 Published:2009-02-20

摘要/Abstract

摘要： 目的分析可逆性后部白质脑病综合症（Reversible posterior leukoencephalopathy syndrome，RPLES）的临床和影像学特点，探讨其发病机制。方法报道6例RPLES患者的临床表现和影像学结果。结果本组病例的临床表现包括：头痛、视野缺损、癫痫发作和认知改变。病因包括：高血压病控制不良、子痫、使用免疫抑制剂和醛固酮增多症。影像学改变：对称或不对称的以后部颞顶枕为主的病变，一些病例以脑干病变为主，表现为长T1/T2信号，平扫液体衰减反转恢复序列（fluid attenuated inversion recovery，FLAIR）成像为高信号，弥散加权成像（Diffusion-weighted imaging，DWI）和表观弥散系数（Apparent diffusion coefficient，ADC）均为高信号，梯度回波序列（T2*-weighted gradient-echo MR image，GRE）显示广泛性微出血。结论多种病因可引起RPLES，其病理机制主要为脑血管痉挛、微梗死、微出血和脑组织水肿。

关键词: 可逆性后部白质脑病综合症; 诊断显像

Abstract: To explore the pathomechanism of reversible posterior leukoencephalopathy syndrome by analyze its clinical and neuroimaging characteristics.Methods The clinical manifestation and neuroimaging findings of 6 cases of reversible posterior leukoencephalopathy syndrome were reported.Results The clinical manifestation of this series included headache, visual disturbances, epilepsy and altered mental functioning. The causes involved were mal-controlled hypertension, eclampsia, cyclosporine A, hyperaldosteronism and so on. The neuroimaging findings were T1-hypointense/T2-hyperintense, Flair-hyperintense lesions predominantly in posterior temple-parieto-occipital regions symmetrically or asymmetrically.However,the lesions in some cases were mainly in brainstem. DWI of the affected areas showed slightly increased values ,meanwhile, apparent diffusion coefficient (ADC) maps showed high values in that areas. The T2*-weighted gradient-echo MR image displayed marked microhemorrhages widespread throughout, predominantly in posterior circulation.Conclusion Reversible posterior leukoencephalopathy syndrome is associated with miscellaneous causes. Vasospasms, micro-infarctions, microhemorrhages and vasogenic edema mainly contribute to Pathogenetic courses.

Key words: Reversible posterior leukoencephalopathy syndrome; Diagnostic imaging

张在强;牛松涛;翦凡;于学英;邵晓秋. 可逆性后部白质脑病综合症的临床和影像学分析[J]. , 2009, 4(02): 109-112.

ZHANG Zai-Qiang;Niu Song-Tao;JIAN Fan;et al. . Clinical and Neuroimaging Characteristics of Reversible Posterior Leukoencephalopathy Syndrome [J]. , 2009, 4(02): 109-112.

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