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目的探讨可逆性后部脑病综合征(RPES)的临床特征和 MRI 表现。方法回顾性分析4例经临床诊断 RPES 的临床和 MRI 资料。结果 4例患者均有血压升高,神经症状有剧烈头痛(2例)、烦躁不安(3例)、视觉模糊(2例)、近期记忆力减退(1例)、癫癎发作(2例);MRI 上病灶主要对称性分布于顶叶后部及枕叶(4例),表现为 T_2加权像及压水像高信号,T_1加权像低信号,2例主要累及皮质,1例表现皮质及皮质下白质同时受累,1例主要累及白质。4例复查时病灶明显消散。结论 RPES 的 MRI 表现较为有特征性,病灶多对称性分布于大脑后部,累及皮质或皮质下白质,为可逆性病灶;结合临床血压升高和某些后部脑结构受累所致神经症状等特点有助于该综合征的早期鉴别诊断。
Objective To investigate the clinical features and MRI findings of reversible posterior encephalopathy syndrome (RPES). Methods The clinical and MRI data of 4 cases of clinically diagnosed RPES were retrospectively analyzed. Results All 4 patients had high blood pressure, severe headache (2 cases), restlessness (3 cases), blurred vision (2 cases), recent memory loss (1 case) and epileptic seizures (2 cases). The main symmetry of MRI lesions in the parietal lobe and occipital lobe (4 cases), manifested as T 2 weighted image and water pressure as high signal, T 1 weighted low signal, 2 cases mainly involving the cortex, 1 case of cortex and cortex Lower white matter at the same time involvement, a case of mainly involving the white matter. Four cases of re-examination of lesions significantly dissipated. Conclusions The MRI findings of RPES are more characteristic. Symmetry of lesion is distributed in the posterior part of the brain, which affects the cortical or subcortical white matter and is a reversible focal lesion. Combined with the clinical rise of blood pressure and the neurological symptoms caused by the involvement of some posterior brain structures Features contribute to the early differential diagnosis of the syndrome.