摘要：

目的总结可逆性胼胝体压部病变综合征的临床表现和影像学特点，探讨其病因和发病机制。方法 回顾分析4 例可逆性胼胝体压部病变综合征患者的临床表现、影像学特点和病因。结果 4 例患者中2 例（例1 和例2）有颅脑创伤史，1 例（例3）于饮酒后出现发作性双眼视物模糊，1 例（例4）于感冒后出现头痛、晕厥，伴间断性视物模糊和慢性肾功能衰竭；MRI 表现为胼胝体压部孤立性圆形或类圆形、边界清晰的病变，呈T₁WI等或稍低信号，T₂WI、扩散加权成像和FLAIR 成像高信号，表观扩散系数低信号，无明显水肿和占位效应，1 例（例2）除胼胝体压部病变外，磁敏感加权成像可见额叶出血。均经对因和对症支持治疗后症状完全缓解，病程8 ~ 15 d。复查MRI，3 例胼胝体异常信号消失，1 例（例2）病变信号范围和强度较前明显好转，均未遗留神经功能障碍。结论 可逆性胼胝体压部病变综合征是一种临床影像学综合征，病因多样，癫痫及其相关疾病是最常见病因，颅脑创伤也可以引起可逆性胼胝体压部病变综合征，临床表现无特异性，经对因治疗后预后良好。

关键词: 胼胝体, 脑疾病, 颅脑损伤, 磁共振成像

Abstract:

Objective To investigate the clinical and imaging characteristics and to describe the etiology and possible pathophysiological mechanisms of reversible splenial lesion syndrome (RESLES). Methods Clinical, radiological data and etiology of 4 cases with RESLES were retrospectively analyzed. Results Two (Case 1 and Case 2) of the 4 patients were caused by traumatic brain injury (TBI), one (Case 3) presented paroxysmal blurred vision after drinking, and the last one (Case 4) suffered from headache and syncope, intermittent blurred vision and chronic renal failure after cold. Cerebral MRI of all patients revealed solitary round lesions with clear boundary in the splenial of corpus callosum, which had isointensity or slightly low - intensity T₁WI signal, high - intensity signal in T₂WI, FLAIR and diffusion - weighted imaging (DWI), low-intensity signal of apparent diffusion coefficient (ADC), without edema and mass effect. Susceptility-weighted imaging (SWI) revealed frontal hemorrhage in one case (Case 2) expect for splenial lesion. After etiological and symptomatic treatment, the patients were all relieved, with duration for 8-15 d. MRI reexamination showed abnormal signals of corpus callosum disappeared in 3 patients, and were improved in the other case (Case 2). Neurologic sequelae was not found. Conclusions RESLES is a kind of clinical imaging syndrome with a wide variety of etiologies. One of the most common causes is epilepsy and related disease. Trauma may also be one of the etiologies. The most common clinical manifestations of RESLES are nonspecific, and the prognosis is good after etiological treatment.

Key words: Corpus callosum, Brain diseases, Craniocerebral trauma, Magnetic resonance imaging