Abstract：
Contrast-induced encephalopathy (CIE) is a rare complication of imaging using ionidated contrast media. Its pathogenesis remains unknown, and its clinical presentation is variable. We present two cases of CIE following coronary angiography (CAG) that underscore the multitude of clinical manifestations and imaging findings associated with the disorder. In patient 1, CIE manifested during the CAG with agitation and decreased consciousness, followed by left hemiparesis and visual neglect. Native computed tomography (CT) of the head was unremarkable but CT perfusion (CTP) showed extensive hypoperfusion of the right hemisphere with corresponding slow-wave activity in the electroencephalogram (EEG). These findings were more pronounced the next day. Magnetic Resonance Imaging (MRI) revealed multiple small dot-like ischemic lesions across the brain. By day 6, she had fully recovered. Patient 2 developed transient expressive aphasia during the CAG followed by migraineous symptoms. Native head CT showed a large area of parenchymal edema, sulcal effacement and variable subarachnoid hyperdensity in the right hemisphere. He developed mild left-side hemiparesis, spontaneous gaze deviation and inattention. Brain MRI showed small dot-like acute ischemic lesions across the brain. The next morning, he had a generalized tonic-clonic seizure (GTCS) after which native head CT was normal, but the EEG showed a post-ictal finding covering the right hemisphere. His hemiparesis resolved within 2 months. The diversity in clinical and radiographic presentations suggest that CIE involve many pathophysiological processes.
摘要：
造影剂诱发的脑病（CIE）是使用电离造影剂成像的罕见并发症。其发病机制尚不清楚,其临床表现是可变的。我们介绍了两例冠状动脉造影（CAG）后的CIE病例，这些病例强调了与该疾病相关的多种临床表现和影像学发现。在患者1中，CIE在CAG期间表现为躁动和意识下降，其次是左偏瘫和视觉忽视。头部的自然计算机断层扫描（CT）不明显，但CT灌注（CTP）显示右半球的广泛灌注不足，脑电图（EEG）中相应的慢波活动。这些发现在第二天更加明显。磁共振成像（MRI）显示大脑中有多个小的点状缺血性病变。到第六天，她已经完全康复了。患者2在CAG期间出现短暂性表达性失语,随后出现偏头痛症状。头颅CT显示大面积实质水肿，右半球沟消失和蛛网膜下腔高密度变化。他出现了轻微的左侧偏瘫,自发的凝视偏差和注意力不集中。脑MRI显示整个大脑中出现小的点状急性缺血性病变。第二天早上,他患有全身性强直阵挛性癫痫发作（GTCS），此后固有的头部CT正常，但是脑电图显示了一个覆盖右半球的术后发现。他的偏瘫在两个月内解决了。临床和影像学表现的多样性表明CIE涉及许多病理生理过程。
