弥漫粟粒型脑结核的MRI诊断  

MRI Diagnosis of Diffuse Miliary Tuberculosis of Brain

作　　者：欧卫谦[1] 朱新进[1] 钟应泽[1] 赵继泉[1] 曾惠良[1] 陈学光[1] 

机构地区：[1]广东省佛山市第二人民医院医学影像中心,广东佛山528000

出　　处：《临床医学工程》2011年第12期1846-1848,共3页Clinical Medicine & Engineering

摘　　要：目的探讨弥漫粟粒型脑结核的MRI征象及其诊断价值。方法对14例临床确诊弥漫粟粒型脑结核患者的MRI特点和相关临床资料进行回顾性分析。MR检查采用常规轴位SE T1WI和FSE T2WI、T2FLAIR序列,Gd-DTPA增强扫描包括轴位和冠状位、矢状位SE T1WI序列;抗结核治疗后进行MR随访。统计分析采用SPSS 11.0软件,计量资料采用配对t检验方法。结果 MR平扫对早期结节显示不佳,T1WI、T2WI呈等信号结节,增强扫描结节明显强化,分布较均匀,大小相仿,直径1~5mm。经抗结核治疗,早期表现为水肿程度减轻,随后结节缩小、强化程度减弱或消失。将14病例T2FLAIR及T2WI两个序列显示病灶数进行对比,经统计分析显示：T2FLAIR发现病灶数为39.285±11.371,T2WI为35.000±10.648,配对t值为9.523,P=0.000（P〈0.05）,两种序列对显示弥漫粟粒型脑结核病灶数具有显著差异。结论 MRI能为弥漫粟粒型脑结核的影像诊断及其疗效观察提供客观形态学依据,其中T2FLAIR序列对病灶的显示较T2WI敏感、清楚,是首选的影像学检查方法。Objective To assess the MR features and diagnostic value for diffuse miliary tuberculosis of the brain. Methods 14 cases of clinically diagnosed patients with diffuse miliary brain MRI features of tuberculosis and related clinical data were retrospectively analyzed. MR imaging with conventional axial SE T1WI and FSE T2WI, T2FLAIR sequence, Gd-DTPA enhanced MRI, including axial and coronal, sagittal SE T1WI sequences; anti-TB treatment after the MR follow-up. Statistical analysis using SPSS 11.0 software, measurement data using paired t test. Results MR scan showed poor to early nodules, T1WI, T2WI showed equal signal nodules, scan nodules was obviously enhanced, more uniform distribution, and similar size, diameter of 1 ~ 5 mm. After anti-TB treatment, the early representation was a lighter edema, followed by reduced nodules, strengthening of weakened or disappeared. Compared with T2FLAIR and T2WI of the 14 cases, the statistics showed that： T2FLAIR number of lesions was 39.285 ± 11.371, T2WI was 35.000 ± 10.648, paired t-value = 9. 523, P = 0.000 （P 0.05）, with significant difference between the two sequences in showing diffuse miliary tuberculosis of the brain. Conclusion MRI provides the objective morphological basis for diagnosis and curative effects observation of diffuse miliary brain tuberculosis, in which T2FLAIR sequence has a higher sensitive and clear level than T2WI , and is the preferred imaging examination method.

关 键 词：粟粒型结核 脑 磁共振成像 

分 类 号：R529.3[医药卫生—内科学] R445.2[医药卫生—临床医学]