Analysis of clinical and imaging features of 17 pregnant patients complicated with PRES

Abstract

Objective To investigate the imaging characteristics of pregnant women complicated with posterior reversible encephalopathy syndrome(PRES), in order to improve the understanding of the disease. Methods The clinical and imaging data of 17 pregnant patients complicated with PRES from July 2011 to July 2017 of the People′s Hospital of Huadu District in Guangzhou were analyzed retrospectively. Results All patients were preeclampsia or eclampsia in pregnancy (5 cases with eclampsia, 12 cases with eclampsia). Among them, 8 cases underwent CT examination, 9 cases underwent MRI examination Typical imaging findings were symmetrical subcortical white matter and subcortical cerebral edema presented as irregular low density area on CT images and symmetric subcortical white matter and abnormal cortical signal on MRI fluid-attenuated inversion recovery (FLAIR)images.Diffuse-limited signals were not observed in both DWI and ADC.The location of lesions were parieto-occipital lobes[100.0%(17/17)], followed by frontallobe[88.9%(15/17)], temporal lobe[29.4%(5/17)], basal ganglia[41.2%(7/17)], corpus callosum[17.6%(3/17)], radiant crown[11.8%(2/17)]and cerebellum[11.8%(2/17)]. After symptomatic treatment, the clinical symptoms of all patients were significantly improved after 1-2 weeks, and no clinical symptoms were observed after 1-3 months of follow-up. Conclusion The characteristic imaging features can be assessed in pregnant patients complicated with PRES, which presented as symmetrical subcortical white matter and subcortical cerebral edema, mainly involved the region supplied by posterior circulation, got good results after treatment timely. Key words: Brain disease; Posterior reversible encephalopathy syndrome; Pregnancy; Cerebral edema vasongenic; Magnetic resonance imaging; Tomography; X-Ray computed; Differential diagnosis