磁共振成像对鞘内注射治疗结核性脑脊髓膜炎疗效的诊断价值

Intrathecal injection therapy in tuberculous cerebrospinal meningitis and MRI follow up

目的探讨MRI对鞘内注射治疗结核性脑脊髓膜炎疗效的诊断价值。方法 200例行鞘内注射治疗的结核性脑脊髓膜炎患者,对比分析治疗前后MRI影像表现。结果 200例中结核性脑脊髓膜炎170例,有效例数170例,占100%。单纯性结核性脑炎4例,单纯性结核性脊髓炎3例,共5例有效,占71.43%。脑结核球并脊髓结核球15例,单纯脑结核球5例,单纯脊髓结核球3例,15例有效,有效率65.22%。所有病变好转有效190例,变化不大或无效10例,两者比较,P<0.001,差异具有统计学意义。结论鞘内注射治疗结核性脑脊髓膜炎效果明显,MRI能很好反映治疗前后的影像变化。

Objective To determine the value of MRI in following up of intrathecal injection therapy in tuberculous cerebrospinal meningitis.Methods 200 cases of tuberculous cerebrospinal meningitis underwent intrathecal injection therapy,and MRI scanned before and after the therapy.Results 170 of the 200 were tuberculous cerebrospinal meningitis,all showed efficacy to the therapy (100%); Pure tuberculous encephalitis (n=4) and tuberculous myelitis (n=3) together demonstrated efficacy in 5 cases (71.43%).Brain tuberculoma complicated by spinal cord tuberculoma (n=15),pure brain tuberculoma (n=5),and pure spinal cord tuberculoma (n=3) all together revealed efficacy to therapy in 15 cases (65.22%).Totally 190 cases improved after therapy which was significantly more than unimproved cases (n=10) (P<0.001).Conclusions Intrathecal injection therapy is effective for tuberculous cerebrospinal meningitis.MRI is a good approach to follow up the curative effect.