单发脑实质型脑囊虫病的影像诊断

Imaging Diagnosis of Single Parenchymal Type Cerebral Cysticercosis

目的分析CT和MRI对不同时期单发脑实质型脑囊虫病的诊断价值。资料与方法回顾性分析63例经临床确诊的单发脑实质型脑囊虫病患者的影像资料,11例仅行CT检查,52例同时行CT和MRI。结果全部病变均位于幕上,其中额叶32例,顶叶20例,颞叶5例,枕叶4例、基底节区2例。根据病程将单发脑实质型脑囊虫病分为4期:急性期"脑炎"型(4例),存活期(24例),退变坏死期(30例),纤维钙化期(5例)。存活期囊内见头节影为典型表现,即"牛眼征";退变坏死期CT平扫见单个点状或小结节状钙化灶,T2WI呈"白靶征"、"多环、分层征",T2WI上"白靶征"及高信号囊液于液体衰减反转恢复序列(FLAIR)呈低信号,增强后在脑水肿的皮质侧可见结节状、环状明显强化。结论 CT和MRI对单发脑实质型脑囊虫病可作出明确诊断,并可为临床进行分期。

Objective To evaluate CT and MRI diagnostic value of single parenchymal type cerebral cysticercosis in different stages. Materials and Methods Sixty-three patients with single parenchymal type cerebral cysticercosis verified by clinic were retrospectively analysed.11 patients had CT scan,and 52 cases had both CT and MRI examinations. Resu-lts All the lesion were located in supratentorial brain：frontal lobes（n=32）,parietal lobes（n=20）,temporal lobes（n=5）,occipital lobes（n=4）,basal ganglia（n=2）. Based on CT and MRI characteristics,the disease could be divided into four stages：acute phase ＂encephalitis＂ type （n=4）,active stage（n=24）,degenerative and necrotic stage（n=30）,calcific stage（n=5）. It was typical maniflestations that scolices were seen in cysts（namely＂oxeye＂sign） in active stage. In degenerative and necrotic stage,a single punctual or a small nodule calcification was seen in plain CT images,and showed as ＂white target sign＂,＂multi-ring sign,delaminated sign＂ on T2WI,the＂white target sign＂ and hyperintensity hydatid fluid appeared as hypo-intensity on FLAIR. On contrast-enhanced CT or MR imaging,nodular or circular enhancement could be seen at cortex sides of encephaledema regions. Conclusion CT and MRI exam is helpful for making a correct diagnosis to single parenchymal type cerebral cysticercosis,and could make clinical stages.