结核性脑膜炎的多层螺旋CT及MRI影像特点及诊断价值分析

Imaging features and diagnostic value of multi-slice spiral CT and MRI in tuberculous meningitis

目的探讨多层螺旋CT和MRI应用于结核性脑膜炎中的诊断效果和影像特征。方法选取在2016年5月~2017年9月期间我院接收的结核性脑膜炎患者84例,所有患者均予以多层螺旋CT和MRI检查,记录影像学特征。结果多层螺旋CT和MRI检查异常征象主要包含脑膜增厚、脑梗死灶、不同程度脑积水、基底池或鞍池或脑实质不同密度;MRI诊断阳性率83.33%(70/84),高于多层螺旋CT的64.28%(54/84),差异有统计学意义(P<0.05);经过CT平扫证实脑积水、脑梗死、单发或多发结核异常变化,呈现等密度或稍高密度影像变化,少数伴随钙化;增强扫描过程中呈现为环状或结节状强化,少数不强化;MRI呈现为脑底部脑池形态变窄或消失。结论MRI检查诊断结核性脑膜炎的阳性率要高于多层螺旋CT,两种检查均能够为结核性脑膜炎患者的病变位置及累及范围提供精准诊断,但是相对来说MRI检查效果更加显著,有利于临床推广分析。

Objective To investigate the imaging features and diagnostic value of multi-slice spiral CT and MRI in tuberculous meningitis.Methods 84 patients with tuberculous meningitis were enrolled in our hospital from May 2016 to September 2017.All patients underwent multi-slice spiral CT and MRI,and the imaging features were recorded.Results The abnormal signs of multi-slice spiral CT and MRI mainly included meningeal thickening,cerebral infarction,different degrees of hydrocephalus,and different density of basal pool or saddle pool or brain parenchyma.The positive rate of MRI diagnosis was 83.33%(70/84),which was higher than 64.28%(54/84)of multi-slice spiral CT,and the difference between the two groups was statistically significant(P<0.05).CT scan confirmed hydrocephalus,cerebral infarction,single or multiple tuberculosis abnormal changes showed equal density or slightly high-density image changes,a small accompanying calcification.Enhanced scanning showed a ring-shaped or nodular enhancement,a few did not show enhancement.MRI appeared as the narrow and disappearance of the bain bottom pool shape.Conclusion The positive rate of MRI in the diagnosis of tuberculous meningitis is higher than that of multi-slice spiral CT.Both examinations can provide accurate diagnosis for the location and extent of tuberculous meningitis,but the MRI examination has more significant effect.It is conducive to clinical promotion analysis.