CT与MRI对结节性硬化症的诊断价值

DIAGNOSTIC VALUE OF CT AND MRI FOR TUBEROUS SCLEROSIS

目的探讨结节性硬化症影像学表现及CT与MRI对其诊断的价值。方法回顾性分析45例临床确诊为结节性硬化症病人的影像学资料。结果 CT检查45例病人均可见室管膜下结节。MRI检查39例病人显示皮质及皮质下结节,可见脑实质内异常信号影,T1加权像(T1WI)序列呈低信号,T2WI序列呈高信号。MRI检查,8例(18.0%)见室管膜下星形细胞瘤;腹部CT平扫加增强扫描,9例(20.0%)合并肾脏血管平滑肌脂肪瘤,2例(4.4%)合并肝脏血管平滑肌脂肪瘤;胸部CT平扫加增强扫描,3例(6.7%)合并肺血管淋巴管肌瘤病。结论结节性硬化症是一种可累及多系统多器官的综合征,CT显示室管膜下钙化结节具有特征性诊断价值;MRI对非钙化性结节比较敏感,能发现更多病变。CT及MRI联合检查对结节性硬化症的定性诊断有重要价值。

Objective To investigate the imaging manifestations of tuberous sclerosis and the value of CT and MRI in the diagnosis of the disease. Methods Imaging data of 45 cases of clinically confirmed tuberous sclerosis were retrospectively re- viewed. Results CT examination showed subependymal nodules in all the 45 cases. MRI examination.. 39 cases showed cortical and subcortical nodules. Abnormal signal, T1WI sequence was low signal, and T2WI sequence was high signal could be seen in brain parenchyma. MRI showed eight （18.0 %） cases of subependymal astrocytoma, abdominal plain plus enhancement CT scan showed nine （20.0%） were combined with renal angiomyolipoma and two （4.4%） accompanying hepatic angiomyolipoma. Plain and enhanced chest CT indicated three （6.7%） cases combined with pulmonary vascular lymphangiomyomatosis. Conclusion Tuberous sclerosis is a syndrome that can involve multiple systems and multiple organs. CT demonstrates subependymal calcified nodules is of mark diagnostic value, and MRI is more sensitive to non-calcified nodules, and more lesions can be found. A combina- tion of CT and MRI for qualitative diagnosis of tuberous sclerosis is of great value.