脑血吸虫肉芽肿的MRI表现

The clinical observation of cerebral schistosomal granuloma

目的 总结分析脑血吸虫肉芽肿的MRI表现及临床特征。方法 搜集资料完整的脑血吸虫肉芽肿 11例 ,其中7例经手术病理证实 ,4例结合临床和实验室检查证实 ,对临床特点进行回顾性分析。采用 1 0TMR扫描机 ,全部病例均行增强扫描。结果 6例单发 ,5例多发 ;病灶主要位于顶叶 (5例 )、枕叶 (5例 )、颞叶 (4例 )、额叶 (3例 )、小脑半球 (1例 )。平扫呈团、片状异常信号 ,T1WI为低、等信号 ,T2 WI为高信号 ,周围水肿明显 ,增强扫描有多个小结节状、斑点状强化 ,并呈“泥砂样”聚集成团。结论 脑血吸虫肉芽肿的MRI表现有很高的特异性 ,MRI对本病的诊断和鉴别诊断有重要价值。

Objective To discuss the diagnostic value of MRI in cerebral schistosomal granuloma through analyzing the MRI features, clinical characteristic, and post-surgery pathological findings. Methods 11 patients with cerebral schistosomal granuloma proved by pathological examination (n=7) or clinical materials (n=4) were studied in the study. The MRI features and pathological findings were analyzed retrospectively. Plain and enhanced MRI were performed in all patients with Siemens 1.0 T MRI scanner. Results Single lesion was found in 6 cases, and multiple lesions were found in 5 cases. Most lesions were located in parietal lobe (5 cases), occipital lobe(5 cases), temporal lobe(4 cases), frontal lobe(3 cases), and epencephalon lobe(1 case). All the lesions were iso-or hypo intensity on T 1WI, hyperintensity on T 2WI, with multiple nodules, spot or silt-like enhancement with tendency to aggregate, and periphery edema. Conclusion MRI manifestations of cerebral schistosomal granuloma have specific features, and MRI is the most valuable tool for diagnosis and differential diagnosis of this disease.