肝泡状棘球蚴病脑播散的MRI表现

MRI Features of Brain Alveolar Echinococcosis Hematogenous Disseminated from Liver

目的分析肝泡状棘球蚴病脑播散的MRI表现,评价MRI在诊断中的应用价值。资料与方法回顾分析10例经手术证实肝泡状棘球蚴病患者因出现神经系统症状经检查发现合并脑内多发播散灶的MRI表现。结果 10例中,8例MRI表现为脑内多发肿块,其内"蜂房"状或"筛孔"状密集的细小囊泡影,T1WI病灶信号略高于脑实质,T2WI呈明显低信号,增强扫描周边见环状强化,其内强化浅淡,并见细小针孔状不强化区。另2例MRI表现为囊泡较大,且数十个聚集呈"葡萄串"状,囊壁T1WI略高于脑实质,T2WI呈明显低信号,增强扫描囊壁明显强化,其内囊液不强化。结论脑内病灶多分布在双侧大脑半球,尤其是大脑中动脉血供区的大脑半球后部。MRI不仅能明确病变部位和形态特点,而且病灶囊壁及基质在T2WI具有典型低信号特征,是诊断肝泡状棘球蚴病脑转移的安全可靠的方法之一。

Objective To analyze the MRI features of brain alveolar echinococcosis disseminated from liver.Materials and Methods The MRI findings of 10 patients with brain alveolar echinococcosis proved by pathology were analyzed retrospectively.Results There were 2 types of MRI features in ten cases.The first type（n=8） of MRI features included multiple tumor like lesions,with honeycomb or cribriform pattern vesicles insided.The lesions showed hyperintensity on T1WI and significant hypointensity on T2WI.After contrast,the lesions showed rim enhancement.Another type（n=2） of MRI features included big vesicles,in clusters as bunch of grapes.The walls of vesicles showed hyperintensity on T1WI and significant hypointensity on T2WI.After contrast,the wall of lesions were enhanced and the cysts were no enhanced.Conclusion The lesions of brain alveolar echinococcosis most frequently locate in the hemispheres,particularly in the territory of the middle cerebral artery.MR can show not only the location and shape,but also the signal characteristics.MR is a safe and reliable method for the diagnosis of alveolar echinococcosis.