| Reversible posterior encephalopathy syndrome (RPES) are with signs and symptoms of rapid progress, bilateral cerebral hemispheres rear reversible white matter lesions occur for typical imaging findings, the nature of vasogenic edema. Most significantly higher blood RPESsure, or suffering from some underlying disease, MRI is an important diagnostic RPES inspection methods, DWI and ADC sequence can identify ischemic brain lesions of cytotoxic edema and vasogenic edema RPES. If timely diagnosis and treatment, symptoms and radiographic abnormalities can be completely back to normal; If delay in treatment will result in persistent neurological dysfunction and even death.Objective:The objectives in RPESent study are:to explore RPES magnetic resonance (NMR) and to evaluate the clinical value of performance characteristics, as well as to improve clinical doctors know RPES, and do early diagnosis and correct recognition and early treatment.Method:Collected during January 2011-2014 January 30 cases diagnosed in patients with MRI, MRI features were retrospectively analyzed. ADC values measured 30 cases RPES lesions in patients classified as disease group, while matched age, sex are the same healthy volunteers, measured obtaining the corresponding parts of the ADC value, included in the control group, these the two groups were compared.Results19 cases of 30 patients are male, the rest 21 are females, which shows that the proportion of women is higher. The most common diseases are caused by hypertension and gestational hypertension pre-eclampsia or preeclampsia. Secondary to pregnancy-induced hypertension syndrome,17 cases (60.3%),7 cases (23.3%), hypertension disease and other diseases are because of systemic lupus erythematosus (SLE) in 1 case,1 case of allergic purpura, nephrotic syndrome (3 cases). Another finding is 1 case of sjogren’s syndrome.2 Incidence of acute blood RPESsure often occurs in the acute phase was significantly higher, a few slightly elevated or normal, the clinical manifestations of headache, epilepsy, impaired consciousness, visual disturbances Fallot most common.330 patients were performed routine MRI scan, DWI, ADC, MRA and MRV scanning, display the parietal lobe,28 cases (93.3%) are involved, at the same time with occipital lobe involvement 26 cases (86.7%), other parts of the posterior circulation can also be affected, such as 6 cases (20%), cerebellum, midbrain, and bridge head 4 cases (13.3%), corpus callosum in 1 case (3.3%). Before, except the posterior circulation loop can also be affected,10 cases (33.3%), such as the frontal temporal lobe, Basal ganglia involvement 5 cases (16.7%), the thalamus,4 cases (13.3%) and ventricular narrator mass in 3 patients (10%), The vast majority of lesions in the occipital lobe, also involving these parts.The characteristics of magnetic resonance imaging RPES mainly show the back of the brain cortex and subcortical lesions. T1WI shows similar or slightly low signal. T2WI and FLAIR sequences show higher signal and high signal in FLAIR is more obvious. DWI has a similar or slightly low signal, and the ADC figure show high signal..Lesions ADC value 0.712-1.256 ×10-3 mm/s, with an average of 1.116×10- mm/s, while the control group compared with ADC values 0.623-0.83610-3mm2/s, an average of 0.726× 10 mm/s, P value of 0.043, is lower than the control group ADC lesion group, the difference was statistically significant (P<0.05). The review of 30 cases in the RPESent group after the treatment (2 weeks later) by magnetic resonance imaging (MRI) shows that 8 cases of lesions from the previous significantly reduced and 22 cases were completely disappeared.4 A clear diagnosis of the disease to be unique by its clinical manifestations and MRI unique performance, coupled with the symptoms, signs and imaging after treatment returned to normal after two weeks or significantly improved.Conclusion:RPES main clinical symptoms are headache, dizziness, seizures, unconsciousness, visual impairment. Because of its common symptoms of hypertensive encephalopathy and gestational hypertension or preeclampsia-eclampsia. Magnetic resonance imaging features of the main manifestations of symmetry T1 low signal to the rear of the brain cortex and cortex, T2 hyperintensity, long FLAIR signal more significant; etc., or slightly lower DWI signal, ADC map shows a high signal was measured Measuring disease and control groups ADC value changes, the lesion was significantly higher than the control group. After treatment, clinical symptoms and magnetic resonance imaging characteristics can be completely back to normal, indicating that the general prognosis is good, if not timely diagnosis and treatment, it can cause irreversible neurological damage. |
PDF Full Text Request