Karia S J, Rykken J B, McKinney Z J, Zhang L, McKinney A M
From the Department of Radiology (S.J.K., J.B.R., A.M.M.)
From the Department of Radiology (S.J.K., J.B.R., A.M.M.).
AJNR Am J Neuroradiol. 2016 Mar;37(3):415-22. doi: 10.3174/ajnr.A4563. Epub 2015 Nov 12.
Posterior reversible encephalopathy syndrome is a clinicoradiologic syndrome. Literature regarding associated factors and the prognostic significance of contrast enhancement in posterior reversible encephalopathy syndrome is sparse. This study set out to evaluate an association between the presence of enhancement in posterior reversible encephalopathy syndrome and various clinical factors in a large series of patients with this syndrome.
From an MR imaging report search that yielded 176 patients with clinically confirmed posterior reversible encephalopathy syndrome between 1997 and 2014, we identified 135 patients who had received gadolinium-based contrast. The presenting symptoms, etiology, clinical follow-up, and maximum systolic and diastolic blood pressures within 1 day of MR imaging were recorded. MRIs were reviewed for parenchymal hemorrhage, MR imaging severity, and the presence and pattern of contrast enhancement. Statistical analyses evaluated a correlation between any clinical features and the presence or pattern of enhancement.
Of 135 included patients (67.4% females; age range, 7-82 years), 59 (43.7%) had contrast enhancement on T1-weighted MR imaging, the most common pattern being leptomeningeal (n = 24, 17.8%) or leptomeningeal plus cortical (n = 21, 15.6%). Clinical outcomes were available in 96 patients. No significant association was found between the presence or pattern of enhancement and any of the variables, including sex, age, symptom, MR imaging severity, blood pressure, or outcome (all P > .05 after Bonferroni correction).
The presence or pattern of enhancement in posterior reversible encephalopathy syndrome is not associated with any of the tested variables. However, an association was found between MR imaging severity and clinical outcome.
后部可逆性脑病综合征是一种临床影像学综合征。关于后部可逆性脑病综合征相关因素及对比增强的预后意义的文献较少。本研究旨在评估后部可逆性脑病综合征患者中对比增强的出现与各种临床因素之间的关联。
通过对1997年至2014年间176例临床确诊为后部可逆性脑病综合征患者的磁共振成像报告进行检索，我们确定了135例接受钆基对比剂检查的患者。记录其出现的症状、病因、临床随访情况以及磁共振成像检查前1天内的最高收缩压和舒张压。对磁共振成像进行复查，观察脑实质出血情况、磁共振成像严重程度以及对比增强的出现情况和模式。统计分析评估任何临床特征与增强的出现或模式之间的相关性。
在纳入研究的135例患者中（女性占67.4%；年龄范围为7至82岁），59例（43.7%）在T1加权磁共振成像上有对比增强，最常见的模式为软脑膜增强（n = 24，17.8%）或软脑膜加皮质增强（n = 21，15.6%）。96例患者有临床结局数据。未发现增强的出现或模式与任何变量之间存在显著关联，包括性别、年龄、症状、磁共振成像严重程度、血压或结局（经Bonferroni校正后，所有P > 0.05）。
后部可逆性脑病综合征中增强的出现或模式与任何测试变量均无关联。然而，发现磁共振成像严重程度与临床结局之间存在关联。
