颅内结核的MRI诊断(附73例报告)

MRI diagnosis of intracranial tuberculosis (73 cases report)

目的探讨颅内结核的MRI表现、分型及诊断价值。方法回顾性分析73例经手术病理或临床证实的颅内结核的MRI表现,其中结核性脑膜炎39例,单纯性结核瘤12例,结核瘤并脑膜炎22例。结果结核性脑膜炎主要表现为脑梗塞、脑积水、脑膜及脑基底池的异常增强。成熟型结核瘤12例、以T2WI呈高或低信号以及环形异常增强为其特征表现;非成熟型结核瘤22例,灶周水肿较明显,多呈结节状均匀强化。FLAIR对病灶的显示较T2WI清楚,增强扫描对小病灶的显示较平扫更明确。结论MRI在诊断颅内结核方面具有比较特征性的表现,在显示病变部位、范围、分型及制定治疗方案上有重要价值。

Objective To assess the MRI features, classification and diagnostic value for intracranial tuberculosis. Methods MRI findings of 73 patients suffering from intracranial tuberculosis proved by pathology or clinic were analyzed respectively. Among the total 73 patients, 39 cases were tuberculosis meningitis, 12 cases simple intracranial tuberculoma, while 22 cases were tuberculoma combining with meningitis. Results The MRI features of tuberculous meningitis are cerebral infarction,hydrocephalus, abnormal meningeal and cerebral cistern enhancement. 12 cases mature tuberculoma demonstrated typical features with high or low density on T2WI images and ring contrast enhancement; 22 cases non-mature tuberculoma showed focal nodular contrast enhancement with evident cerebral edema. FLAIR is more sensitive to find out focus than T2WI. Small lesions could be showed definitively by contrast-enhanced scan. Conclusion MRI possess typical features in the diagnosis of intracranial tuberculosis. It plays an important role in evaluating location, range, classification of intracranial tuberculosis, and is helpful to clinical treatment.