粟粒性脑结核的MRI诊断与鉴别诊断

MRI Diagnosis and Differential Diagnosis of Cerebral Military Tuberculosis

目的探讨粟粒性脑结核及与其需要鉴别疾病的MRI特点。方法 2007年12月2009年10月,对11例粟粒性脑结核患者的MRI平扫及增强表现进行分析,总结其MRI特征性表现。结果病史上粟粒性脑结核多存在血行播散型肺结核,平扫表现为多发小片影,增强后表现为弥漫分布的小环状或结节状强化灶,大小趋向一致,多为2mm左右,可合并结核性脑膜炎及脑积水。结论粟粒性脑结核的MRI平扫表现不典型,增强表现有一定特征性,认识其特点可以和其它常见的颅内多发病变进行鉴别。

Objective To analyze the MRI appearances of cerebral military tuberculosis and other diseases that need to differentiate.Methods From December 2007to October 2009,the MRI appearances of 11cases on the plain scan and the enhanced MRI scan after injection of Gd-DTPA were reviewed and summarized.Results The cases of cerebral military tuberculosis usually had the history of military pulmonary tuberculosis,showed multiple lesions in fragments on plain scan,and the lesions distributed diffusely after enhancement,showed as ring form or nodosity.The size tended to be uniform,often 2mm in diameter approximately.Tuberculosis meningitis and hydrocephalus could accompany.Conclusion The manifestation of plain MRI is not typical,and the enhancement MRI is imperative.Some characteristic appearances can be found after injection of Gd-DTPA,and these characteristic appearances could be helpful to differentiate with other multiple intracranial diseases.