四脑室囊虫病的磁共振成像诊断

MRI Diagnosis of Cerebral Cysticercosis in the Fourth Ventricle

目的 探讨磁共振成像 (MRI)对四脑室囊虫病的诊断价值。方法 回顾性分析经临床证实的 3 2例四脑室囊虫病的MRI表现特点。脑MRI全部采用德国Siemens 1.0TImpact超导型MRI机 ,选用SE序列。 2 1例有脑CT对照。 结果 3 2例四脑室囊虫病中 ,单纯性四脑室囊虫 17例 ( 5 3 .1% ) ,混合型 15例 ( 4 6.9% )。四脑室内单发囊虫 3 0例 ,多发 2例。囊泡在T1WI上等于或稍高于CSF信号 ,而在T2WI上等于或稍低于CSF信号。囊虫壁在T1WI上呈边缘光滑的细线样稍高信号影 ,而在T2WI上低于CSF信号。囊虫头节在矢状面T1WI上显示较为清楚 ,其中有 2 4例附着于囊泡内壁的前下壁上 ;其在T1WI上与脑实质信号相近 ,而在T2WI上信号复杂 ,可表现为低于、等于或高于CSF的信号。CT难以显示四脑室囊虫头节或囊壁。结论 MRI是诊断四脑室囊虫病的首选影像学检查方法 ,对四脑室囊虫的诊断MRI优于CT。

Objective To explore the diagnostic value of magnetic resonance imaging (MRI) for cerebral cysticercosis in the fourth ventricle.Methods Characteristic MRI appearances of 32 patients with cerebral cysticercosis verified by MRI and clinic were retrospectively analyzed.MRI examinations of the brain were performed with a superconductive 1.0T Impact MR Unit,and SE sequence was used in all patients.MRI findings were compared with plain cerebral CT findings in 21 cases of them.Results Of the 32 cases with cerebral cysticercosis in the fourth ventricle,there were two types,including intraventricular type (17/32,53.1%) and mixed type (15/32,46.9%).Single and multiple cerebral cysticercosis of the fourth ventricle were detected in 30 and 2 patients, respectively.Compared with the CSF,the cyst of cerebral cysticercosis in the fourth ventricle presented as iso- or slightly hyper-intensity on T1WI and iso- or slightly hypo-intensity on T2WI; most walls of cerebral cysticercosis showed as smooth and sharp linear slight high signal intensity on T1WI,and low signal intensity on T2WI.Twenty-four scolex which attached to the anterior or inferior inner wall of the cyst could be well seen on T1WI of the sagittal plane.The signal intensity of the scolex was similar to that of the cerebral parenchyma on T1WI and very complicated on T2WI,which showed low,moderate or high signal intensity.The wall and the scolex of cysticercosis in the fourth ventricle were difficult to be seen on CT scan.Conclusion MRI is the best choice and is superior to CT for the diagnosis of cerebral cysticercosis in the fourth ventricle.