Fuldem Yildirim Donmez MD, Presenter: Nothing to Disclose

Ceyla Basaran MD, Abstract Co-Author: Nothing to Disclose

Mahir Yildirim MD, Abstract Co-Author: Nothing to Disclose

Mehmet Coskun MD, Abstract Co-Author: Nothing to Disclose

To report the clinical and radiological features of posterior reversible encephalopathy and compare our findings to the literature.

The brain MRI and clinical records of 33 patients were retrospectively evaluated. 24 patients had follow-up imaging, which confirmed the reversibility of the lesions, 9 patients were clinically followed and recovered. The clinical records were analyzed for the age, sex, gender, underlying etiology and clinical symptoms. MRI images were evaluated for the distribution of the lesions, contrast enhancement and diffusion-weighted-imaging (DWI) features and complications.

The most commonly involved localizations were frontal lobe in 51.5%, parietal lobe in 84.8%, occipital lobe in 72.7%, temporal lobe in 33.3%, cerebellum in 33.3 %.19 patients had DWI which showed vasogenic edema in 17 and cytotoxic edema in 2. 16 patients had contrast-enhanced images, 4 of them showed focal enhancement. 9 patients had the complication of hemorrhage.

The involvement of different localizations formerly known as atypical is now commonly encountered. Intravenous contrast administration may be of use to demonstrate focal enhancement and exclude other diseases in the differential. DWI is essential to distinguish the type of edema, and repeat imaging including DWI should be performed to follow the response to therapy. Gradient-echo sequences should be acquired to demonstrate any potential complication such as hemorrhage.

Patients presenting with acute symptoms suggesting PRES should be evaluated with diffusion-weighted and gradient-echo sequences in addition to T2-weighted images.

Donmez, F, Basaran, C, Yildirim, M, Coskun, M, MRI Features of Posterior Reversible Encephalopathy Syndrome in 33 Patients.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6011302.html