MRI对肥厚性硬膜炎的诊断价值观察  

Diagnostic value of MRI in hypertrophic pachymeningitis

作　　者：史丽静 陆伟 郭勇 黄敏华 邵立新 左拥军 王守海 魏倩倩 

机构地区：[1]海军总医院磁共振室,北京100048

出　　处：《解放军医学杂志》2016年第2期149-152,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨MRI在肥厚性硬膜炎诊断中的应用价值。方法对海军总医院2009年9月-2014年12月收治的11例肥厚性硬膜炎患者的MRI图像进行回顾性分析,归纳其在MRI不同成像方法图像中的征象以及与肥厚性硬膜炎病理改变的联系。结果 11例肥厚性硬膜炎中8例累及硬脑膜,2例累及硬脊膜,1例同时累及硬脑膜及硬脊膜。MRI图像主要表现为硬膜增厚,增厚的硬膜在T_1WI呈等或略低信号,与脑实质和脊髓信号差异较小,在T_2WI表现为较明显低信号,与脑实质及脊髓对比显示清晰。9例硬脑膜受累者均进行了DWI扫描,增厚的硬膜呈较低信号,但显示的清晰程度及与周围的对比度不如常规T_2WI。增强后T_1WI扫描显示增厚的硬膜呈较明显强化,显示效果明显好于增强前。结论MRI各种成像方法中,T_2WI及增强后的T_1WI对HP的显示和诊断比较有优势,其余成像手段可作为必要补充,以全面显示其他相关病变,提高诊断准确率和全面性。Objective To investigate the diagnostic value of MRI in hypertrophic pachymeningitis（HP）. MethodsMRI images of 11 patients with HP were analyzed retrospectively. The characteristic signs of the MRI images, and the relationship between the MRI features and pathology of HP were reviewed. Results In the 11 cases of HP, involvement of cerebral dura mater accounted for 8 cases, with spinal dura mater involvement in 2, both cerebral and spinal dura mater involvement in the other one case. The main sign of HP in MRI was an increased thickness of the dura mater, which showed iso- or hypointensity on T_1 WI without significant difference as compared with the brain parenchyma and spinal cord. The thickened dura mater showed obviously low signal on T_2 WI, and it was recognized easily as compared with the brain parenchyma and the spinal cord. On the DWI of 9 cases who had cerebral dura mater involvement, increased dura mater showed lower signal, but it was not so distinct as shown on T_2 WI. On the post-contrast T_1 WI, the thickened dura mater showed obvious enhancement, displaying better images than that of preenhancement image. Conclusion Among the different MRI techniques, T_2-weighted imaging and post-enhanced T_1 WI have their advantages in the diagnosis of HP, and other MR imaging techniques could be complementary in increasing diagnostic accuracy and comprehensiveness.

关 键 词：肥厚性硬膜炎 磁共振成像 诊断 

分 类 号：R814.16[医药卫生—影像医学与核医学]