结核性脑膜炎神经系统损害的MRI诊断

MRI Diagnosis of Central Nervous System Damages Caused by Tuberculous Meningitis

目的 探讨MRI在诊断结核性脑膜炎神经系统损害中的价值。材料与方法 对 5 3例经手术或临床证实的结核性脑膜炎患者进行MRI检查 ,获取头部矢状位T1WI、横断位T1WI及T2 WI ,部分病例加作颈胸段MRI。所有患者均进行Gd DTPA增强检查。结果 硬脑膜增厚、脑池及脑沟闭塞 40例 ,脑血管炎及脑梗塞 2 8例 ,脑结核球 12例 ,脑积水 16例 ,脑萎缩 2 3例 ,视交叉及视神经损害 2例 ,脊膜、脊髓损害 4例。结论 MRI在诊断结核性脑膜炎神经系统损害中具有重要价值。

Objective To evaluate MRI in diagnosing tuberculous meningitis.Materials and Methods With a GE Signa 0.5T MR unit, T 1WI、T 2WI and Gd-DTPA enhanced scanning were performed in 53 patients with surgically-or clinically-proved tuberculous meningitis. MRI findings were analyzed.Results MRI manifestations were as follows: thickened cerebral dura mater and obliteration of cerebral cistern and sulcus (n=40), cerebral vasculitis and infarction (n=28), intracranial tuberculoma (n=12), dilated ventricles (n=16), damage of optic chiasm and optic nerve (n=2), and damage of spinal dura mater and cord (n=4).Conclusion MRI plays an important role in evaluating nervous system damages caused by tuberculous meningitis.