核磁共振表现为硬脑膜强化的同像异病

Clinical analysis of different cases with pachymeningeal enhancement on magnetic resonance imaging

目的探讨核磁共振以硬脑膜强化为影像学特点的疾病的临床表现与诊断,以提高对以核磁共振硬脑膜强化为特征的相关疾病的认识。方法回顾性分析2017年2月至2019年10月就诊于我院的以核磁共振表现为硬脑膜强化的5例患者的临床资料与辅助检查结果,分析不同硬脑膜强化疾病的特点。结果5例患者核磁共振表现极其相似,均表现为硬脑膜强化,但临床诊断各不相同:1例为特发性肥厚性硬脑膜炎;1例为IgG4相关性肥厚性硬脑膜炎;1例为低颅压综合征;1例为脑静脉窦血栓;1例为脑膜瘤。结论核磁共振表现为硬脑膜强化的同像异病复杂多样,治疗方法及预后不同,应结合病史及其他辅助检查仔细鉴别以明确诊断,避免误诊。

Objective To investigate the clinical manifestations and diagnosis of the diseases with the imaging characteristics of pachymeningeal enhancement on magnetic resonance imaging(MRI),in order to improve the understanding of the diseases with pachymeningeal enhancement on MRI.Methods The clinical data and auxiliary examination results of 5 patients with pachymeningeal enhancement on MRI from February 2017 to October 2019 were analyzed retrospectively,and the characteristics of each patient were analyzed.Results MRI was similar in all five patients.All of them showed pachymeningeal enhancement,but the clinical diagnosis was different:1 case was idiopathic hypertrophic pachymeningitis;1 case was IgG4-related hypertrophic pachymeningitis;1 case was intracranial hypotension syndrome;1 case was cerebral venous sinus thrombosis;1 case was meningoma.Conclusions The etiology,treatment and prognosis of diseases with pachymeningeal enhancement on MRI are complex,history and other auxiliary examination should be combined carefully to identify the diagnosis,avoiding misdiagnosis.