结节性硬化神经影像表现的再认识

Neuroradiology of Tuberous Sclerosis

目的：分析结节性硬化（TS）的CF和MRI影像表现特征。材料与方法：经临床诊断为结节性硬化患者中，20例经CT检查；4例MRI检查，其中2例既有CT又有MR检查，结果：结节性硬化的影像表现主要征象有：（1）皮层结节病灶，其表现有脑回核心样病灶、H型病灶。（2）白质异常表现在MRI上可见，病灶呈四块状和薄放射带状。（3）室管膜下结节最常见于侧脑室外侧壁和莫氏孔区，CT对这一病灶的检出优于MR，在MR上，T1WI又优于T2WI和PD相。（4）室管膜下巨细胞星形细胞瘤均位于莫氏孔区这一特定的解剖部位，这一肿瘤常有强化，而且肿瘤逐渐增长。结论：神经影像学检查对确诊TS起到很大作用，CT比MR特异性强，但敏感性略低，两项检查对发现和确定病变有互补作用。

Objective: To analyz CT and MRI characteristic features of tuberous sclerosis. Materials and Methods: 22 patients of tuberous sclerosis, 20 cases had CT scanning, and 4 cases had MRI scanning, 2 of which had both CT and MRI examination. Results: There were mainly four findings of tuberous sclerosis on imaging: (1 )The patterns of cortical tubers were gyral core lesion, H-shaped lesion and a rare kind of feature on MRI and high or low densitymass in CT. (2)The abnormal findings of white matter were tumefactive fool or radial linear type of thin bands on MR images. (3) Subependymal nodules were mest commonly along the lateral wall of the lateral ventricles, and near the caudate nucleus or caudothalamic sulcus. They were detected easier in CT than on MRI, and more distinctive on T_1WI than on proton-density and T_2WI. (4) Some features of subependymal grant cell astrocytoma were their anatomy location at or near the fomina of Morno, tumor enhancement and mass growth continuously. Conclusion: Neuroradiology could play great part in making diagnosis of tuberous sclerosis. CT was more specific but less sensitive than MRI, and both of them were complementary for detecting lesions of tuberous sclerosis.