摘要
目的 探讨可逆性胼胝体压部病变综合征(RESLES)患者的临床和MRI表现.方法 回顾性分析26例RESLES患者的临床资料和MRI影像表现特点.结果 本组患者中,男20例,女6例,年龄3～38岁,中位年龄20.5岁,其中21例为发热起病,伴头痛15例,呕吐8例,咽喉痛3例,咳嗽3例,头晕5例,神志异常5例,言语不清4例,抽搐2例,步态不稳2例,深昏迷3例;5例无前驱感染症状,其中癫痫发作2例,多动症1例,双侧颊部痛1例,肢体麻木1例.早期MRI表现为胼胝体压部孤立性病变,多为圆形或椭圆形,T1WI呈等信号或稍低信号,T2WI呈稍高信号,FLAIR为稍高信号,DWI呈明显高信号,ADC呈低信号,边界尚清,无水肿及占位效应,增强扫描无强化.随访发现24例患者临床症状完全消失,2例预后不良.复查MRI显示所有胼胝体压部病灶消失,1例双侧脑桥出现异常信号.结论 RESLES患者MRI表现为具有特异性的胼胝体压部孤立性可逆性病变,结合其前驱感染症状等临床特点,有利于其早期诊断及鉴别诊断,为临床诊治提供重要的参考依据.
Abstract
Objective To investigate the clinical and dynamic change of MRI features of reversible splenial lesion syndrome (RESLES).Methods The clinical data and MRI findings of 26 patients with RESLES were retrospectively analyzed.Results These patients included 20 males and 6 females,and their age varied from 3 to 38 years (median 20.5).20 of 26 patients had initial symptoms of fever,subsequent concomitant symptom included headache (15/21),emesis(8/ 21),pharyngalgia (3/21),cough (3/21),dizziness (3/21),cloudiness of consciousness (5/21),inarticulate speech (4/21),tic (2/21),gait instability (2/21),deep coma (3/21).5 of the 26 patients had no preceding infection,and suffered from epilepsy (2/5),hyperactivity (1/5),pain of the pars buccalis (1/5),numbness of the limbs (1/5).The initial MRI revealed focal oval or round lesions located in the splenium of corpus callosum with clear boundary,including slight hypointensity on T1 WI,slight hyperintensity on T2WI and FLAIR,significant hyperintensity on DWI and significant hypointensity on ADC without edema and mass effect.No obvious enhancement could be detected.24 patients completely recovered after treatment,but 2 patients had a poor prognosis.Follow-up MR examinations showed complete lesion disappearance in the splenium of corpus callosum,but 1 patient showed additional lesion on both sides of the pons.Conclusion The MRI findings of RESLES are characterized by the reversible lesion of the splenium,contributing to differential diagnosis and providing an important reference basis for clinical diagnosis and prognosis combined with clinical characteristics of preceding infection.
NETL
NSTL
维普
万方数据