磁共振成像对高原地区颅内非肿瘤性环形强化病变的鉴别诊断价值

Diagnostic Value of Intracranial Non-neoplastic Annular Enhanced Lesions by MRI

目的分析高原地区颅内非肿瘤性环形强化病灶的核磁共振成像(MRI)影像特点。方法回顾性分析2014年6月~2016年3月西藏某三甲医院颅脑MRI检查为环状强化患者43例,其中15例为脑结核瘤、28例为脑囊虫脑实质型。比较其MRI特点,并进行统计学分析。结果 MRI平扫显示:脑结核瘤累及范围较局限(73%),形态多不规则(60%),所有病例均存在周围组织水肿,脑室挤压发生率为53%;脑囊虫累及范围较弥漫(89%),形态多为类圆形(93%),周围组织水肿较少(25%),所有病例无脑室受压;两种疾病比较,差异有统计学意义(P<0.05)。MRI增强扫描显示:脑结核瘤与脑囊虫均表现为环形强化;脑结核瘤环壁较厚,环壁多毛糙,47%病例有脑膜强化;脑囊虫环壁较薄,环壁光滑,无脑膜强化;两种疾病比较,差异有统计学意义(P<0.05)。结论 MRI平扫的形态学特点及增强扫描的强化环特点相结合对高原地区颅内非肿瘤性环形强化病灶的鉴别诊断具有较好的临床应用价值。

Objective:To analyze the imaging features of MRI in intracranial non-neoplastic annular enhanced lesions.Methods:Retrospectively analyzed MRI features of 43 cases with intracranial annular enhanced lesions(15 patients with intracranial tuberculoma,28 patients with cerebral parenchyma type cysticercosis),which confirmed in our hospital from June 2014 to March 2016.Results:(1)Among the patients with intracranial tuberculoma,MRI scans showed that patients with cerebral hemorrhage,the rate of ventricle compression was 53%,most tumors had an irregular shape with the involved scope limited.However,in patients with cerebral cysticercosis,MRI scans showed that patients without ventricle compression and associated with less cerebral hemorrhage.(2)MRI enhancement scans showed that two diseases with annular enhanced lesions,the annular wall of intracranial tuberculoma was thicker and coarse,47 percent with meningeal enhancement.In addition,the annular wall of cerebral cysticercosis was thinner and smooth,and without meningeal enhancement,difference between two diseases with statistical significance(P<0.05).Conclusions:MRI scans combined with annular enhancement sign on enhanced MRI scans has very important value in diagnosis of intracranial non-neoplastic annular enhanced lesions.