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The radiologic diagnosis of posterior reversible encephalopathy syndrome<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
ABSTRACT
Objective：To investigate the radiologic findings of posterior reversible encephalopathy syndrome（PRES）.
Materials and Methods：The clinical and radiologic data were analyzed retrospectively in 12 patients，including of nine cases with pre－eclampsia/eclampsia，two with hyperintensive encephalopathy（HE） and one with drug neurotoxity induced by cyclosporine A（CSA）. MRI was performed in all 12 cases，in which seven cases had Gd－DTPA contrast enhancement study，four cases had been performed with three dimensional time of flight magnetic resonance angiography（3D－TOF MRA） and one with diffusion－weighted imaging（DWI） as well.CT was performed in seven patients. Digital subtraction angiography（DSA） was performed in two patients.
Results：MRI showed bilateral symmetrically distributed lesions，mainly located in cortex and subcortical white matter of parieto－occipital lobes with iso－intensity or slightly low－intensity on T1WI and increased signal intensity on T2WI.FLAIR showed hyper－intensity in cortex and subcortical white matter more obviously and clearly than T1WI and T2WI did. No apparently abnormal contrast enhancement was found after intravenously injected Gd－DTPA.Increased signal intensity on DWI was found in cortex of bilateral parietal，occipital and frontal lobe in one case，while the proximal subcortical white matter with increased signal intensity on ADC map. CT studies of four cases showed symmetric plaque－like low－attenuated lesions in bilateral parietal，occipital and frontal lobes. CT findings of other three cases were normal. Follows－up CT or MRI showed complete or nearly complete absorption of lesions after adequate clinical treatments.
Conclusion：PRES has characteristic CT and MRI findings. MRI should be the first choice for the diagnosis.
Key Words：Reversible；Brain disease；Syndrome；Tomography，computed；Magnetic resonance imaging | 
