Clinical and radiological features and screening of risk factors of reversible posterior encephalopathy syndrome in preeclampsia patients

Abstract

Objective To analyze clinical and radiological features of preeclampsia combined with reversible posterior encephalopathy syndrome (RPES) and screen related risk factors.  Methods Clinical data of 111 preeclampsia patients were recorded, including age, number of pregnancies, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hemoglobin, blood platelet count, serum creatinine (Cr) and plasma D?dimer. Head MRI were examined in all patients. Univariate and multivariate forward Logistic regression analysis were used to screen related risk factors of preeclampsia combined with RPES. Results In 111 patients, 42 were combined with RPES. Logistic regression analysis showed headache (OR = 70.958, 95%CI: 6.578-765.447; P = 0.000), visual disturbance (OR = 3.966, 95%CI: 1.290-12.191; P = 0.016), SBP (OR = 1.034, 95%CI: 1.006-1.064; P = 0.019) and serum Cr (OR = 1.060, 95%CI: 1.000-1.123; P = 0.048) were independent risk factors of preeclampsia combined with RPES. MRI showed the lesions of preeclampsia combined with RPES were located in frontal lobe (17 cases, 40.48% ), temporal lobe (6 cases, 14.29% ), parietal lobe (32 cases, 76.19% ), occipital lobe (35 cases, 83.33%), brain stem (4 cases, 9.52%), cerebellum (7 cases, 16.67%) and basal ganglia (22 cases, 52.38%). MRI showed T1WI hypointensity, T2WI and FLAIR hyperintensity, diffusion ? weighted imaging (DWI) hyperintensity and apparent diffusion coefficient (ADC) hypointensity.  Conclusions Headache, visual disturbance, SBP and serum Cr level are independent risk factors of reeclampsia combined with RPES, which are closely related to the onset of RPES.

DOI: 10.3969/j.issn.1672-6731.2018.05.008