The clinical significance of MSCT and 3.0T MRI in the diagnosis of reversible posterior leukoencephalopathy syndrome

Objective:To evaluate the imaging manifestations and clinical significance of MSCT and MRI in the reversible posterior leukoencephalopathy syndrome(RPLS).Methods:The clinical and imaging data of 15 RPLS patients were retrospectively analyzed.Results:The RPLS lesions located mainly in bilateral posterior subcortical white matter,the manifestation of MRI was the hyperintensities of T2WI and FLAIR.The manifestation of MSCT was the subcortical low density shadow,and the diffusion-weighted images(DWI) in part of lesions were hyperintensities.The lesions of bilateral cerebral hemisphere involved in 15 cases,which included 14 cases(93.3%) in occipital lobe,15 cases(100.0%)in parietal lobe,14 cases(93.3%) in frontal lobe,9 cases(60.0%) in temporal lobe,3 cases(20.0%)in bilateral basal ganglia region and 3 cases(20.0%) in the right side of the basal ganglia region.Three cases(20.0%) in cerebellum,1 case(6.7%) in brain stem and 2 cases(13.3%) in corpus callosum were identified.Among 13 patients detected by DWI,the upper DW1 of 13 cases(100%) were isoheight and high signal.The apparent diffusion coefficient(ADC)mapping of part of lesions in 6 cases were low signal.The abnormal cerebral artery and vein imaging in 3 cases of MR venography and 2 cases of MR artery angiography were not found.Compared with MSCT,the imaging of MRI could clearly show the lesions,and involve more scope,especially in showing the FLAIR sequence.The lesions in 3 cases were significantly improved after treatment,and even disappeared.The softening lesions in the right temporooccipital parietal lobe of 1 case was found because of delayed diagnosis.Conclusions:The prognosis of RPLS is usually benign,and RPLS has the characteristical imaging change,particularly in MRI performance.The imaging characteristics of PRLS should be awared,the early diagnosis and treatment can aviod the permanent neurological sequlae.