隐球菌性脑膜脑炎的CT、MRI影像表现及其诊断意义

Characteristics and Evaluation of CT and MRI Findings in the Diagnosis of Crytococcus Meningoencephalitis

目的 :探讨隐球菌性脑膜脑炎的CT及MRI影像表现及其诊断价值。材料和方法 :回顾对比分析 2 6例经脑脊液墨汁染色证实隐球菌脑膜脑炎头颅CT及MRI的影像学改变。结果 :早期CT及MRI表现为正常、弥漫性脑水肿、轻度脑积水 ;亚急性期及慢性期表现为脑萎缩、脑积水、胶状假囊、脑内多灶低密度区及异常信号区、隐球菌瘤 ,脑膜增厚、强化 ,以基底池、环池、侧裂池及四叠池为著 ;脑内强化血管影增多。结论 :CT及MRI检查对隐球菌性脑膜脑炎病变部位、病理形态及变化、发展的阶段可提供定位的诊断依据 ,有助于临床分型、病期的判定、选择治疗方案及估计预后、治疗情况。

Purpose: To search for the main neuroradiological features of patients with cryptococcus meningoencephalitis (CM) and to evaluate value of CT and MRI in diagnosing CM. Materials and Methods: The findings of CT and MRI were retrospectively analyzed in 26 cases with India ink capsule staining proved CM. Results: CT and MRI scans showed as follows: normal or diffuse cerebral edema or mild hydrocephalus at acute stage of CM; Brain atrophy、hydrocephalus、gelatinous pseudocysts、cryptococcomas、multiple low density and abnormally signal intensity, thickened cerebral dura mater and more meningeal enhancement at basal cistern、sylvian、lateral sulcus、quadrigeminal cistern and sulci, and abnormal more enhanced blood vessel at subacute and chronic stage infection. Conclusion: CT and MRI can provide useful information which are the basis for localization of lesion, ascertaining the extent and type and development stage of lesion, give help to choosing of treatment planning and estimating prognosis of CM.