| 杨洋,袁新宇,王瑶,胡梦泽,刘嵘,石玉铸.儿童异基因造血干细胞移植后可逆性后部白质脑综合征MRI表现[J].中国医学影像技术,2021,37(6):810~814 |
| 儿童异基因造血干细胞移植后可逆性后部白质脑综合征MRI表现 |
| MRI findings of posterior reversible encephalopathy syndrome after allogeneic hematopoietic stem cell transplantation in children |
| 投稿时间：2021-02-21 修订日期：2021-04-25 |
| DOI：10.13929/j.issn.1003-3289.2021.06.003 |
| 中文关键词: 儿童 造血干细胞移植 后部白质脑病综合征 磁共振成像 |
| 英文关键词:child hematopoietic stem cell transplantation posterior leukoencephalopathy syndrome magnetic resonance imaging |
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| 中文摘要: |
| 目的 观察儿童异基因造血干细胞移植（allo-HSCT）后可逆性后部白质脑综合征（PRES）MRI表现。方法 纳入23例allo-HSCT后PRES患儿，观察MRI所示病变累及范围、信号特点及随访变化。结果 23例顶枕叶皮质及皮质下白质均受累，21例双侧受累，2例单侧受累；7例累及额颞叶皮质及皮质下白质，3例累及深部白质，2例累及丘脑，累及胼胝体、基底节及小脑各1例。病灶于T1WI呈等或低信号，T2WI和液体衰减反转恢复（FLAIR）序列图像呈高信号，边缘模糊；14例弥散加权成像（DWI）示条片状高信号；ADC图中，皮质、皮质下及深部白质区病灶呈稍高或等信号，丘脑、基底节及小脑病灶呈稍低信号。对9例间隔10~75天（中位时间26天）复查MR，皮质及皮质下白质异常信号全部消失，4例仍可见部分丘脑及基底节病变。结论 allo-HSCT术后PRES累及范围及其MRI表现具有特征性；综合分析DWI与ADC信号特点可辅助及时诊断、积极干预，对改善患儿预后具有重要意义。 |
| 英文摘要: |
| Objective To observe MRI manifestations of posterior reversible encephalopathy syndrome (PRES) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. Methods A total of 23 cases with PRES after allo-HSCT were enrolled. The lesion involvement range, signal characteristics and changes during follow-up showed on MRI were observed. Results Involvement of cortex and subcortical white matter in parietooccipital lobes were observed in all 23 cases, including 21 with bilateral and 2 with unilateral involvements. Involved cortex and subcortical white matter in frontal temporal lobes were detected in 7 cases, while involved deep white matter and thalamus were noticed in 3 and 2 cases, respectively, and involved callosum, basal ganglia and cerebellum was found in each 1 case. The lesions were iso-intense or hypo-intense on MR T1WI, and on T2WI and FLAIR sequence were with hyper-intense with blurred edges. Patchy high-intense on DWI was observed in 14 cases. ADC images showed slightly hyper- or iso-intense lesions in cortex, subcortical white matter and deep white matter, and slightly hypo-intense lesion in thalamus, basal ganglia and cerebellum. Nine cases underwent of MRI following-up with the interval of 10-75 days (median 26 days), indicating that all abnormal signals in cortex and subcortical white matter disappeared, but some remained in thalamus and basal ganglia. Conclusion The distribution and MRI signals of PRES after allo-HSCT in children had certain characteristics. Comprehensive analysis of DWI and ADC was of great significances for early diagnosis, timely treatment and prognosis judgment. |
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