脑结核的CT诊断

CT diagnosis of tuberculosis of the brain

目的:探讨脑结核的CT表现及诊断价值。材料与方法:回顾性分析40例经临床、实验室检查确诊脑结核患者的CT表现。结果:单纯脑膜受累者18例,脑实质受累者9例,脑膜及脑实质同时受累者13例。脑膜受累的CT表现为基底池(47.5%,19蛐40)、侧裂池(37.5%,15蛐40)、四叠体池(40%,16蛐40)、环池(32.5%,13蛐40)正常结构消失,呈等密度或稍高密度,其特征性CT表现为增强扫描时鞍上池、侧裂池、四叠体池、环池呈斑片状、结节状或均匀性、广泛性强化。脑实质受累的CT表现为脑结核瘤(27.5%,11蛐40)、脑脓肿(25%,10蛐40)、脑粟粒结节(2.5%,1蛐40)。结论:CT检查能为脑结核患者的病变部位、累及范围、病变类型、病理学形态提供准确的定位、定性诊断。

Objective: To study the diagnostic and classification value of cerebral tuberculosis with CT imaging. Materials and Methods: CT scans were performed in 40 cases with tuberculosis of the brain confirmed by clinical and laboratory examination of CSF. Results: Eighteen cases were meningeal type, 9 cases were parenchymal type and 13 cases were mixed type. CT scans of the meningeal type showed isodense or slightly hyperdense of the suprasellar cistern(47.5%, 19/40),cistern of Sylvian fissure(37.5%, 15/40),quadrigeminal cistern(40%, 16/40),ambient cistern(32.5%, 13/40). Characteristic enhanced CT scans showed patchy,nodular or uniform,extensive hyperdense of the suprasellar cistern,cistern of Sylvian fissure,quadrigeminal cistern and ambients cisterna. CT scans of the parenchymal type showed tuberculoma(27.5%, 11/40),brain abscess(25%, 10/40),miliary nodutes(2.5%, 1/40). Conclusion: CT examination can offer correct evidence of extent of lesions, pathologic morphology of the lesions and can also provide correct localization and specific diagnosis of cerebral tuberculosis.