title: Utility and Significance of Gadolinium-Based Contrast Enhancement in Posterior Reversible Encephalopathy Syndrome.
abstract: OBJECTIVE
  Posterior reversible encephalopathy syndrome is a clinicoradiologic syndrome. Literature regarding associated factors and the prognostic significance of contrast enhancement in posterior reversible encephalopathy syndrome is sparse. This study set out to evaluate an association between the presence of enhancement in posterior reversible encephalopathy syndrome and various clinical factors in a large series of patients with this syndrome.
  
  
  METHODS
  From an MR imaging report search that yielded 176 patients with clinically confirmed posterior reversible encephalopathy syndrome between 1997 and 2014, we identified 135 patients who had received gadolinium-based contrast. The presenting symptoms, etiology, clinical follow-up, and maximum systolic and diastolic blood pressures within 1 day of MR imaging were recorded. MRIs were reviewed for parenchymal hemorrhage, MR imaging severity, and the presence and pattern of contrast enhancement. Statistical analyses evaluated a correlation between any clinical features and the presence or pattern of enhancement.
  
  
  RESULTS
  Of 135 included patients (67.4% females; age range, 7-82 years), 59 (43.7%) had contrast enhancement on T1-weighted MR imaging, the most common pattern being leptomeningeal (n = 24, 17.8%) or leptomeningeal plus cortical (n = 21, 15.6%). Clinical outcomes were available in 96 patients. No significant association was found between the presence or pattern of enhancement and any of the variables, including sex, age, symptom, MR imaging severity, blood pressure, or outcome (all P > .05 after Bonferroni correction).
  
  
  CONCLUSIONS
  The presence or pattern of enhancement in posterior reversible encephalopathy syndrome is not associated with any of the tested variables. However, an association was found between MR imaging severity and clinical outcome.
authors.affiliation: From the Department of Radiology (S.J.K., J.B.R., A.M.M.) karia009@umn.edu.
authors.forename: S J
authors.identifier: http://orcid.org/0000-0002-8711-5681
authors.initials: SJ
authors.lastname: Karia
authors.affiliation: From the Department of Radiology (S.J.K., J.B.R., A.M.M.).
authors.forename: J B
authors.identifier: http://orcid.org/0000-0002-1958-2448
authors.initials: JB
authors.lastname: Rykken
authors.affiliation: Clinical Informatics (Z.J.M.), Hennepin County Medical Center, St. Louis Park, Minnesota Midwest Center for Occupational Health and Safety/HealthPartners (Z.J.M.), Minneapolis, Minnesota.
authors.forename: Z J
authors.identifier: http://orcid.org/0000-0002-1858-8426
authors.initials: ZJ
authors.lastname: McKinney
authors.affiliation: Clinical and Translational Science Institute (L.Z.), University of Minnesota, Minneapolis, Minnesota.
authors.forename: L
authors.identifier: http://orcid.org/0000-0002-3067-305X
authors.initials: L
authors.lastname: Zhang
authors.affiliation: From the Department of Radiology (S.J.K., J.B.R., A.M.M.) Department of Radiology (A.M.M.).
authors.forename: A M
authors.identifier: http://orcid.org/0000-0003-2530-5970
authors.initials: AM
authors.lastname: McKinney
mesh_terms: D000328:Adult; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis*; D011379:Prognosis
chemical_list: D003287:Contrast Media; D005682:Gadolinium