肿瘤样炎性脱髓鞘病的CT、MRI表现与临床

CT and MRI on tumor like inflammatory demyelinating disease

目的 探讨貌似肿瘤的中枢神经系统炎性脱髓鞘病的临床与影像学特点 ,分析误诊原因 ,并归纳诊断及鉴别诊断要点。方法 对 14例经术后病理检查确诊的中枢神经系统炎性脱髓鞘病患者的临床资料、影像学改变进行分析。结果 中枢神经系统炎性脱髓鞘病 CT或 MRI检查可以出现水肿及占位效应 ,增强后可以有环形强化 ,很难与中枢神经系统肿瘤相鉴别。本组 14例患者术前均误诊为中枢神经系统肿瘤。结论中枢神经系统炎性脱髓鞘病 CT或 MRI可以有肿瘤样的非典型性表现 ,不易鉴别 ,容易造成误诊。应结合临床表现、病程、实验室检查及影像学特征多方面进行鉴别诊断。

Objective To investigate the clinical and imaging characteristics of tumor like inflammatory demyelinating disease of CNS, We have analyzed the reason of misdiagnosis, and summed up the main point of differential diagnosis.Methods We have analyzed 14 cases which were confirmed as demyelinating disease in pathology after the operation, and all the clinical and image data were included.Results CNS inflammatory demyelinating disease could present edema and mass effect by CT or MRI, there was ring potentialization after enhancement, it was difficulty to distinguish from CNS demyelinating disease. All the 14 patients were misdiagnosis as CNS tumor before the operation.Conclusion CNS inflammatory demyelinating disease could have some atypical representation on CT or MRI image, they were made easily the misdiagnosis. We should get the differential diagnosis by many ways including clinical manifestation, course, laboratory examination and imaging characteristics.