弓形体脑病的MRI诊断（附4例报告及文献复习）  

MRI of the toxoplasmosis encephalopathy （ report of 4 cases with literatures review）

作　　者：周粟[1] 施裕新[1] 张志勇[1] 沈杰[1] 蒋超[1] 

机构地区：[1]上海市（复旦大学附属）公共卫生临床中心放射科,上海201508

出　　处：《世界感染杂志》2009年第1期25-29,共5页World Journal of Infection

摘　　要：目的探讨弓形体脑病的MRI表现。方法搜集了4例诊断为弓形虫脑病的头颅MRI片，复习了近几年国内外文献，探讨弓形体脑病的MRI表现。结果弓形虫脑病的头颅MRI表现为：（1）多数病灶位于大脑半球皮质髓质交界处，基底节区，小脑，脑干及侧脑室旁，少数也可见脑膜受累。（2）病灶往往为多发，呈结节状、片状，周围有水肿带，占位效应。（3）平扫T1WI呈边界不清的等低信号影，T2WI呈明显的高信号；有的病变内见T1WI小斑点状高信号，T2WI呈低信号灶。增强后呈不同程度的结节状、片状或环状强化，累及脑膜者可有脑膜强化。MRS对观察病灶的发展及转归的代谢变化有价值。MRI所见须与中枢神经系统转移瘤、结核及淋巴瘤等MRI表现相鉴别。结论结合临床资料、MRI可以诊断弓形体脑病，MRS对病情随访有价值。Objective To investigate the MRI appearances of toxoplasmosis encephalopathy. Methods MRI images of 4 cases with toxoplasmosis encephalopathy proved by clinical data were studied with review of the literature. Results The MRI appearances of toxoplasmosis encephalopathy were： （1） Most of lesion were located at the juncture of gray and white matter of cerebral hemisphere, basal ganglia, cerebellum, brain stern and around the lateral ventricle, some of case can view encroaching meninx. （2） The lesions were characterized by multiplicity, presenting as nodosity and large patches, with mass effect or perifocal edema. （3）Unsharp marging equal or low signal intensity on T1 weighted image and obviously high signal intensity on T2 weighted image, sometimes; mottling high signal intensity within lesions on T1 weighted image and low signal intensity on T2 weighted image. The different extent of nodosity, pathy or circular contrast enhancement, with some case, if meninx was encroached, were seen on enhanced T1WI.Differential diagnosis included metastatic tumor, tuberculosis, lymphoma and so forth. MRS is useful in viewing the variation of metabolism in the time course oftoxoplasmosis encephalopathy. Conclusions Combined with clinical data, MRI can diagnose toxoplasmosis encephalopathy, MRS have value in following up pathogenic condition.

关 键 词：弓形体脑病 磁共振成像 

分 类 号：R531.8[医药卫生—内科学] R445.2[医药卫生—临床医学]