Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion-weighted MR images.

摘要: BACKGROUND AND PURPOSE: The recently described posterior reversible encephalopathy syndrome (PRES) classically consists of vasogenic edema in the circulation territories, although conversion to irreversible cytotoxic has been described. We hypothesized that extent prognostic implications and diffusion-weighted MR imaging (DWI) can help predict progression infarction. METHODS: Twenty-two patients with PRES 18 control subjects were examined isotropic DWI. Nineteen regions interest (ROIs) systematically placed, apparent diffusion coefficients (ADCs) computed correlated T2 DWI signal intensity each ROI. RESULTS: abnormalities always present territories circulation. Anterior structures involved 91% patients. ADC values areas abnormal high. More extensive seen a poor outcome than who recovered. In six (27%), high paradoxically normal, which we called pseudonormalized. Abnormal surrounded these areas. Follow-up images two showed infarction pseudonormalized regions. CONCLUSION: Vasogenic involves predominantly but anterior are also frequently involved. combined correlate patient outcome. High associated cerebral may represent earliest sign nonreversibility as severe progresses edema.