摘要：

目的 总结成人可逆性胼胝体压部病变综合征的临床特征，并探讨可逆性细胞毒性水肿形成机制。方法与结果 纳入2017年1月至2019年5月南昌大学第一附属医院诊断与治疗的23例可逆性胼胝体压部病变综合征患者，临床主要表现为头痛头晕、发热、抽搐、意识障碍等，均存在血清白蛋白水平降低。头部MRI共同特点为可逆性胼胝体压部孤立性病灶，呈边界清楚的类圆形，T₁WI呈低信号、T₂WI呈高信号、DWI呈高信号、ADC呈低信号，且于发病第14天病灶逐渐或完全消失。结论 可逆性胼胝体压部病变综合征病因及临床表现复杂，MRI表现为胼胝体压部可逆性类圆形病灶。影像学病灶通常早于临床症状消失。血清白蛋白水平降低可能是其细胞毒性水肿的危险因素。

关键词: 胼胝体, 血清白蛋白, 水肿, 磁共振成像

Abstract:

Objective To analyze the clinical features and mechanism of reversible splenial lesion syndrome (RESLES) in adults. Methods and Results Twenty-three patients with reversible splenial lesion syndrome diagnosed and treated in the First Affiliated Hospital of Nanchang University from January 2017 to May 2019 were included. The clinical manifestations were headache, dizziness, fever, convulsions, disturbance of consciousness, all 23 patients in this group had decreased serum albumin levels. The common feature of head MRI was a reversible isolated lesion of the corpus callosum, which was round-shaped with clear borders, with high signal on T₂WI, low signal on T₁WI, high signal on DWI, and low signal on ADC, and the lesions gradually or completely disappeared on the 14th day of onset. Conclusions The etiology and clinical manifestations of reversible splenial lesion syndrome are complicated. MRI usually presents a reversible round-shaped lesion in the corpus callosum. Imaging lesions usually disappear earlier than clinical symptoms. The decrease of serum albumin level may be a risk factor for cytotoxic edema.

Key words: Corpus callosum, Serum albumin, Edema, Magnetic resonance imaging