MR增强后液体衰减反转恢复序列对柔脑膜病变的诊断价值  

Role of MR contrast-enhanced fluid-attenuated inversion recovery imaging in the diagnosis of leptomeuingeal lesions

作　　者：田伟[1] 李宗芳[1] 包颜明[1] 陈连有[1] 莫茵[1] 孙春涛[1] 顾青[1] 徐江波[1] 

机构地区：[1]昆明医学院第一附属医院MRI室,650032

出　　处：《中华放射学杂志》2007年第6期584-587,共4页Chinese Journal of Radiology

摘　　要：目的评价 MR 液体衰减反转恢复(FLAIR)序列对柔脑膜病变的诊断价值。方法分析17例柔脑膜病变的 MR 平扫 FLAIR、增强 FLAIR 和增强 T_1WI 表现并比较三者对病变高信号的显示。结果柔脑膜病变在 MR 平扫 FLAIR、增强 FLAIR 和 T_1WI 上均呈沿脑沟、脑池弥漫或局部分布的异常脑回样或线样高信号。增强 FLAIR 与增强 T_1WI 对病变显示的比较:7例只在增强 FLAIR 显示病变;7例二者均明显显示病变;2例二者均显示病变,但前者优于后者;另有1例结核性脑膜脑炎的双侧大脑半球脑沟弥漫性病变只在增强 FLAIR 显示,脑池病变二者均显示但前者优于后者。增强与平扫 FLAIR 对病变显示的比较:9例只在增强 FLAIR 显示病变;4例二者均明显显示病变;3例二者均显示病变但前者优于后者;另有1例结核性脑膜脑炎的脑池病变只在增强 FLAIR 显示,双侧大脑半球脑沟弥漫性病变二者均显示但前者优于后者。结论增强 FLAIR 显示柔脑膜病变优于平扫FLAIR 和增强 T_1WI,对于平扫 FLAIR 和(或)增强 T_1WI 怀疑柔脑膜病变时,增强 FLAIR 是必要的检查序列。Objective To evaluate contrast-enhanced fluid-attenuated inversion recovery （FLAIR） imaging in the detection of leptomeningeal lesions. Methods Seventeen patients with a variety of leptomeningeal lesions were analyzed. The MRI protocol included un-enhanced and contrast-enhanced FLAIR images and contrast-enhanced T1WI. Comparisons between contrast-enhanced FLAIR images and T1WI and between un-enhanced and contrast-enhanced FLAIR images were made to determine which sequence better depicted the lesions. Results Leptomeningeal lesions showed as either diffusely or locally abnormal hyper-intensity along sulci or cistern on three sequences. Comparison between contrast-enhanced FLAIR and T1 WI showed that only contrast-enhanced FLAIR revealed the abnormalities in 7, both revealed the abnormalities but the former was superior in 2, and both were conspicuous in 7. In 1 patient of tuberculous meningitis, diffuse abnormalities of sulci were shown only on contrast-enhanced FLAIR, abnormalities of cisterns were shown on both sequences but the former was superior. Comparison between unenhanced and contrast-enhanced FLAIR showed that only contrast-enhanced FLAIR revealed the abnormalities in 9, both revealed the abnormalities but the former was superior in 3, and both were eonspieuous in 4. In 1 patient of tuberculous meningitis, abnormalities of eisterns were shown only on eontrast-enhaneed FLAIR, diffuseabnormalities of sulei were shown on both sequenees but the former was superior. Conclusions Contrast-enhaneed FLAIR images were superior to un-enhaneed FLAIR images and eontrast-enhaneed T1WI in the deteetion of leptomeningeal lesions. Contrast-enhaneed FLAIR images are helpful and should be considered when findings on un-enhanced FLAIR images and/or contrast-enhanced T1 WI are ineonelusive.

关 键 词：脑膜 磁共振成像 对比研究 

分 类 号：R445.2[医药卫生—影像医学与核医学]