肿瘤样脑炎的MRI表现和Gd－DTPA增强的诊断价值

MRI Findings of Tumor-like Cerebritis and the Diagnostic Value of Contrast Enhancement MRI

目的：研究肿瘤样脑炎的ＭＲＩ表现和Ｇｄ－ＤＴＰＡ增强的诊断价值。材料和方法：报告９例肿瘤样脑炎的ＭＲＩ所见，并与１８例脑星形细胞瘤的增强磁共振成像（ＣＥＭＲＩ）表现进行对比分析。结果：肿瘤样脑炎的非增强磁共振成像（ＮＣＭＲＩ）表现为长Ｔ１、长Ｔ２信号，缺乏特征性，其ＣＥＭＲＩ表现为（１）斑片状高信号，大小不一，强弱不一，散在分布。（２）单个或多个结节状增强，（３）脑膜线状增强。（４）血管壁套状增强。脑星形细胞瘤的典型ＭＲＩ表现为结节状增强或为伴有中心坏死的不规则花环状增强。结论：ＣＥＭＲＩ能反映肿瘤样脑炎的炎性渗出、肉芽肿形成、硬膜充血和血管周围炎的病理特点，对肿瘤样脑炎和脑星形细胞瘤的鉴别诊断有重要意义。

Purpose: To study MRI findings of tumor-like cerebritis and the diagnostic value of Contrast Enhancement MRI. Materials and Methods: To report MRI of tumor-like cerebritis on nine cases, and compare with Contrast Enhancement MRI findings of intracranical astrocytomas on eighteen cases. Results: Non Contrast MRI appearance of tumor-like cerebritis is of long T1 and long T2 signal but has no characteristic features. On Contrast Enhancement MRI, the features of tumor-like cerebritis included:(1) irregular flat increased signal intensity;(2) tubercular hyperintensity;(3) enhancement of the inflamed dural membrance;(4) tube-like enhancement along vessels. The typical Contrast Enhancement MRI findings of astrocytomas were nodular type enhancement or irregular ring enhancement with central necrosis. Conclusion: Contrast Enhancement MRI findings can reflect pathological changes of the tumor-like cerebritis which include inflammatory exudation, granulation, dural membrance congestion and paravessel inflammatory infiltration. So the use of Gd-DTPA is very important to differentiate between tumor -like cerebritis and intracranical astrocytomas.