[1]董晓宇,任静,佡剑非.子痫、子痫前期伴非典型部位可逆性后部白质脑病的影像学特征及相关因素分析[J].卒中与神经疾病杂志,2017,24(02):121-125.[doi:10.3969/j.issn.1007-0478.2017.02.010]
　Dong Xiaoyu,Ren Jing,Nao Jianfei..Imaging features and analysis of related factors of pre-eclampsia and eclampsia with atypical lesion of reversible posterior encephalopathy syndrome[J].Stroke and Nervous Diseases,2017,24(02):121-125.[doi:10.3969/j.issn.1007-0478.2017.02.010]
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子痫、子痫前期伴非典型部位可逆性后部白质脑病的影像学特征及相关因素分析()
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《卒中与神经疾病》杂志[ISSN:1007-0478/CN:42-1402/R]

卷:
第24卷
期数:
2017年02期
页码:
121-125
栏目:
论 著
出版日期:
2017-04-26

文章信息/Info

Title:
Imaging features and analysis of related factors of pre-eclampsia and eclampsia with atypical lesion of reversible posterior encephalopathy syndrome
文章编号:
1007-0478(2017)02-0121-05
作者:
董晓宇; 任静; 佡剑非
110004 沈阳,中国医科大学附属盛京医院神经内科
Author(s):
Dong Xiaoyu;  Ren Jing;  Nao Jianfei.
Department of Neurology, The Sheng Jing Hospital Affiliated of China Medical University, Shenyang 110004
关键词:
可逆性后部白质脑病 子痫 子痫前期 磁共振
Keywords:
Reversible posterior encephalopathy syndrome Eclampsia Pre-eclampsia MRI
分类号:
R742
DOI:
10.3969/j.issn.1007-0478.2017.02.010
摘要:
目的 分析子痫、子痫前期合并非典型部位可逆性后部白质脑病(Reversible Posterior Encephalopathy Syndrome,RPES)的影像学特征及相关因素。方法 回顾性分析2010年1月～2015年12月盛京医院确诊的76例子痫、子痫前期合并可逆性后部白质脑病患者的临床与影像学资料,根据颅脑MRI受累部位不同分为典型病例组与非典型病例组,通过对患者的临床表现、生化指标及影像学特点总结,统计分析非典型部位受累的相关因素。结果 44例患者出现非典型部位受累,发生率57.9%,其中双侧基底节受累最为常见(39例,88.6%),其次为小脑受累(14例,31.8%),对非典型部位受累的相关因素进行Logistic回归分析显示,头痛(OR=6.37,CI 1.30～31.33,P=0.023)及痫性发作(OR=5.42,CI 1.68～17.47,P=0.005)与子痫、子痫前期合并非典型部位RPES有关。结论 痫性发作、头痛与RPES非典型部位受累有关。
Abstract:
ObjectiveTo analyze the imaging features and related factors of pre-eclampsia and eclampsia with atypical lesion of reversible posterior encephalopathy syndrome(RPES).Methods Retrospective analysis of 76 patients' imaging and clinical data, diagnosed pre-eclampsia and eclampsia with RPES from January 2010 to December 2015 in Sheng Jing hospital, according to the cranial MRI affected lesions, it was divided into the typical patient group and atypical patient group, based on the patients' clinical manifestations, biochemical indicators and imaging characteristics, analyze the related factors of atypical lesion involved.Results 44 cases of patients had atypical lesions involved, the incidence is 57.9%, bilateral basal ganglia involvement is most common(39 cases, 88.6%), followed by cerebellar involvement(14 cases, 31.8%), when analyzing related factors with atypical lesion, logistic regression analysis showed that headache(OR=6.37, CI 6.37 to 1.30, P=0.023)and seizure(OR=5.42, CI 5.42 to 1.68, P=0.005)are related with atypical lesion involved.Conclusion Seizure and headache are related with atypical lesion involved. while, atypical lesion involvement do not relate with short-term prognosis.

参考文献/References:

[1] Hinchey J,Chaves C,Appignani B,et al.A reversible posterior leukoencephalopathy syndrome[J].N Engl J Med,1996,344(8):334-494.
[2] Kutlesiě MS,Kutlesiě RM,Korateviě GP.Posterior reversible encephalopathy syndrome in eclamptic patients: neuroradiological manifestation, pathogenesis and management[J].Med Pregl,2015,68(1/2):53-58.
[3] Mckinney AM,Short J,Truwit CL,et al.Posterior reversible encephalopathy syndrome: Incidence of atypical regions of involvement and imaging findings[J].American Journal of Roentgenology,2007,189(4):904-912.
[4] Anon.National high blood pressure education program working group report on high blood pressure in pregnancy[J].Am J Obstet Gynecol,1990,163(5 Pt 1):1691-1712.
[5] 董晓宇,张琼予,佡剑非.子痫前期及子痫并发可逆性后部白质脑病患者的影像学与临床分析[J].中国妇幼保健,2012,27(12):1883-1886.
[6] Ekawa Y,Shiota M,Tobiume T,et al.Reversible posterior leukoencephalopathy syndrome accompanying eclampsia: correct diagnosis using preoperative MRI[J].Tohoku J Exp Med,2012,226(1):55-58.
[7] Lee VH,Manno EM,Wijdicks EF,et al.Clinical spectrum of Reversible Posterior Leukoencephalopathy Syndrome[J].Neurology,2006,66(5, 2):A187.
[8] Mckinney AM,Short J,Truwit CL,et al.Posterior reversible encephalopathy syndrome: Incidence of atypical regions of involvement and imaging findings[J].American Journal of Roentgenology,2007,189(4):904-912.
[9] 董晓宇,潘月,安晶,等.子痫前期及子痫性脑病的影像学表现[J].中国现代神经疾病杂志,2010,10(6):674-676.
[10] Mueller-Mang C,Mang T,Pirker A,et al.Posterior reversible encephalopathy syndrome: do predisposing risk factors make a difference in MRI appearance?[J].Neuroradiology,2009,51(6):373-383.
[11] Kazuma Nakagawa MA,Allan H Ropper MU,Arch Neurol 2008 6,et al.Cranial Mr imaging with clinical correlation in pre-eclampsia and eclampsia[J].Diagn Interv Radiol,2005,11(4):189-194.
[12] Walter PM,Karumanchi SA.Molecular mechanisms of pre-eclampsia[J]. Micro Vascular Research,2008,75(6):1-8.
[13] Alaa W,Laila M,Moustafa MR,et al.Posterior reversible encephalopathy syndrome(PRES):restricted diffusion does not necessarily mean irreversibility[J].Pol J Radiol,2015,80(1):210 216.
[14] Mutter WP,Sa KC.Molecular mechanisms of preeclampsia[J].Microvasc Res,2008,75(1):1-8.
[15] 董晓宇,翟志永,佡剑非.孕产期患者急性头痛的临床特点及头部影像学表现[J].医学临床研究,2014,31(10):2004-2007.
[16] Singh RR,Ozyilmaz N,Waller S,et al.A study on clinical and radiological features and outcome in patients with posterior reversible encephalopathy syndrome(PRES)[J].Eur J Pediatr,2014,173(9):1225-1231.
[17] 鄢广平,吴海鸰,高燕.子痫脑病的常规核磁共振成像及磁共振扩散加权成像表现[J].实用医学杂志,2008,24(2):249-251.
[18] Yilmaz K,Cem C,Nilgun Y.Diffusion-weighted Mr imaging of viral encephalitis [J].Neuroradiology,2006,48(7):875-880.
[19] Ay H,Buonanno FS,Schaefer PW,et al.Posterior leukoencephalopathy without severe hypertension: utility of diffusion-weighted MRI[J].Neurology,1998,51(5):1369-1376.

更新日期/Last Update: 2017-04-20