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潜在可逆性及可识别性急性脑病综合征:疾病分类及 MRI 表现。

Potentially Reversible and Recognizable Acute Encephalopathic Syndromes: Disease Categorization and MRI Appearances.

机构信息

From the Department of Radiology (Y.K.), Division of Neuroradiology, University of Minnesota Medical Center, Minneapolis, Minnesota

Department of Radiology (A.M.M.), University of Miami School of Medicine, Miami, Florida.

出版信息

AJNR Am J Neuroradiol. 2020 Aug;41(8):1328-1338. doi: 10.3174/ajnr.A6634. Epub 2020 Jul 2.

Abstract

"Encephalopathy" is a vague term that encompasses varying definitions, often with a nonspecific clinical presentation and numerous possible pathophysiologic causes. Hence, MR imaging plays a crucial role in the early diagnosis and treatment by identifying imaging patterns when there is limited clinical history in such patients with acute encephalopathy. The aim of this review was to aid in remembrance of etiologies of potentially reversible acute encephalopathic syndromes on MR imaging. The differential includes vascular (reversible cerebral vasoconstriction syndrome, transient global amnesia, disseminated intravascular coagulation, and thrombotic microangiopathy), infection (meningitis, encephalitis), toxic (posterior reversible encephalopathy syndrome, acute toxic leukoencephalopathy; carbon monoxide, alcohol-related, medication- and illicit drug-related toxic encephalopathies), autoimmune, metabolic (osmotic demyelination syndrome, uremic, acute hepatic encephalopathy), idiopathic/inflammatory (stroke-like migraine attacks after radiation therapy syndrome), neoplasm-related encephalopathy, and seizure-related encephalopathy.

摘要

“脑病”是一个模糊的术语,包含不同的定义,通常表现为非特异性的临床特征和许多可能的病理生理原因。因此,磁共振成像在急性脑病患者的临床病史有限的情况下,通过识别影像学模式,在早期诊断和治疗中发挥着至关重要的作用。本综述旨在帮助记忆潜在可治疗的急性脑病综合征的病因,鉴别诊断包括血管性疾病(可逆性脑血管收缩综合征、短暂性全面遗忘症、弥散性血管内凝血、血栓性微血管病)、感染(脑膜炎、脑炎)、中毒(可逆性后部脑病综合征、急性中毒性脑白质病;一氧化碳、酒精、药物和非法药物相关中毒性脑病)、自身免疫性疾病、代谢性疾病(渗透压脱髓鞘综合征、尿毒症、急性肝性脑病)、特发性/炎症性疾病(放射性治疗后卒中样偏头痛发作综合征)、肿瘤相关性脑病和癫痫相关性脑病。

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