title: Neuroimaging features in posterior reversible encephalopathy syndrome: A pictorial review.
abstract: Posterior reversible encephalopathy syndrome (PRES) is a radioclinical entity associating nonspecific neurological symptoms (headache, seizures, impairment of alertness, visual disturbances…) occurring in evocative clinical condition (hypertension, eclampsia, immunosuppressor agents, systemic lupus erythematosus…). In the acute stage, the typical imaging finding is a vasogenic edema predominant in the subcortical parietal-occipital white matter. The purpose of this pictorial review is to illustrate the different neuroimaging features of PRES and present key radiological elements to assert diagnosis. In this overview, we examine the following points: the distributions of vasogenic edema, hemorrhage, the varying patterns in diffusion and perfusion, the different types of enhancement encountered and the vascular modifications demonstrated by angiography. The cause of PRES is still unknown. Nevertheless, catheter angiography, MR angiography and MR perfusion features in PRES render further insight into its pathophysiology. Follow-up imaging shows evidence of radiologic improvement in the very large majority of cases in 1 or 2weeks, sometimes in up to 1month. Recurrent PRES attacks are uncommon. Atypical imaging presentation should not reject the diagnosis of PRES in a compatible clinical situation.
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Functional and Diagnostic Neuroradiology, F-75013 Paris, France; Sorbonne Universités, UPMC Univ, Paris 06, France. Electronic address: morgan0185@gmail.com.
authors.forename: Morgan
authors.initials: M
authors.lastname: Ollivier
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Functional and Diagnostic Neuroradiology, F-75013 Paris, France; Sorbonne Universités, UPMC Univ, Paris 06, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bertrand
authors.affiliation: Sorbonne Universités, UPMC Univ, Paris 06, France; AP-HP, Pitié-Salpétrière Hospital, Department of Interventional Neuroradiology, F-75013 Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Clarençon
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Functional and Diagnostic Neuroradiology, F-75013 Paris, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Gerber
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Cerebrovascular Diseases, F-75013 Paris, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Deltour
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Internal Medicine, F-75013 Paris, France.
authors.forename: Fanny
authors.initials: F
authors.lastname: Domont
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Functional and Diagnostic Neuroradiology, F-75013 Paris, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Trunet
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Functional and Diagnostic Neuroradiology, F-75013 Paris, France; Sorbonne Universités, UPMC Univ, Paris 06, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Dormont
authors.affiliation: AP-HP, Pitié-Salpétrière Hospital, Department of Functional and Diagnostic Neuroradiology, F-75013 Paris, France. Electronic address: del.leclercq@gmail.com.
authors.forename: Delphine
authors.initials: D
authors.lastname: Leclercq
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging; D054038:Posterior Leukoencephalopathy Syndrome / Q000000981:diagnostic imaging*
keywords: Arterial spin-labeling; Diffusion magnetic resonance imaging; Hemorrhage; Magnetic resonance imaging; Perfusion imaging; Posterior leukoencephalopathy syndrome