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目的:分析高血压脑病(HE)的MRI表现与临床预后的关系,进一步提高对其MRI表现及发病机制的认识。材料与方法:回顾性分析了56例有详细临床、影像学资料的HE患者,收集患者血压、病因、影像学资料及随访情况,由至少2位高年资影像科医师共同阅片,评价其MRI异常表现、水肿程度和分级评定。结果:HE的MRI表现主要为脑水肿,病灶累及部位比例中顶叶、枕叶与其他各部位相比的差异均有统计学意义(Ρ<0.01);出现细胞毒性水肿16例(28.6%)、脑出血8例(14.2%),两者与脑水肿的较高分级具有相关性(Ρ<0.05)。结论:HE的MRI改变主要为脑水肿表现,出现细胞毒性脑水肿及脑出血提示脑血管内皮细胞损伤或破坏从而影响预后,因此认识HE的MRI不典型表现对其早期诊断和临床预后评价具有重要价值。
Objective: To analyze the relationship between MRI manifestations and clinical prognosis in patients with hypertensive encephalopathy (HE) and further improve their understanding of MRI findings and pathogenesis. Materials and Methods: A retrospective analysis of 56 patients with detailed clinical and imaging data of HE patients, blood pressure, etiology, imaging data and follow-up were collected. At least 2 high-grade imaging physicians read and evaluated the patients MRI abnormalities, edema and grading. Results: The main manifestations of MRI were cerebral edema. There was significant difference between the parietal lobe and occipital lobe in all the lesion-affected sites (P <0.01), cytotoxic edema in 16 cases (28.6%), There were 8 cases (14.2%) of intracerebral hemorrhage, which were correlated with higher grade of cerebral edema (P <0.05). Conclusions: MRI changes of HE are mainly manifested as cerebral edema. The appearance of cytotoxic cerebral edema and cerebral hemorrhage may damage or destroy cerebrovascular endothelial cells and thus affect the prognosis. Therefore, it is important to recognize the MRI atypical features of HE for its early diagnosis and clinical prognosis evaluation value.