MRI在脑裂头蚴病中的临床应用价值  

The clinical application value of MRI in cerebral sparganosis

作　　者：刘长华[1] 刘飞[2] 余晓洁 左敏[1] 杨克勤[1] LIU Chang-hua;LIU Fei;YU Xiao-jie(Department of Radiology,Hanyang Hospital Affiliated of Wuhan University of Science and Technology,Wuhan 430050,China)

机构地区：[1]武汉科技大学附属汉阳医院放射科,武汉430050 [2]荆州市第一人民医院放射科,湖北434000

出　　处：《放射学实践》2019年第9期975-979,共5页Radiologic Practice

摘　　要：目的:探讨MRI在脑裂头蚴病中的临床应用价值。方法:搜集11例经临床确诊的脑裂头蚴病患者,回顾性分析其MRI影像学特征。结果:所有病例均为多发病灶,大部分病灶位于幕上。病灶MRI平扫表现为多发团片状或条片状不规则异常信号,T 1WI呈等、低信号,T 2WI呈等、高信号,病变边界模糊,灶周水肿明显,占位效应较轻,部分病灶局部可见负占位效应;增强扫描大部分病变呈结节状、不规则环状、串珠样及匐行管状明显强化;DWI大部分病灶扩散未见明显受限,呈等、低信号;MRS示病灶NAA峰呈不同程度降低,Cho/NAA增高。5例复查患者中4例可见病灶的位置及形态发生改变。结论:脑裂头蚴病的MRI表现具有一定的特征性,增强扫描表现较有特异性,DWI、MRS及复查对明确诊断及鉴别诊断很有帮助。MRI对脑裂头蚴病的诊断和指导治疗意义重大,更为进一步在体了解病变的病理过程提供了一种无创的、可视化的途径。Objective: To explore and evaluate the clinical application value of MRI in the diagnosis of cerebral sparganosis. Methods: The MRI imaging features of 11 cases with clinically diagnosed cerebral sparganosis were retrospectively analyzed. Results: Multiple lesions were found on MR images in the brain parenchyma in all cases,and most of them were located in the supratentorial region.The lesions manifested as multiple patchy or strip irregular abnormal signals:equal or low signal intensity on T 1WI and equal or high signal intensity on T 2WI.The boundary of lesions were fuzzy and there was obvious edema around the lesions;however,the occupying effect was mild,and even negative occupying effect was observed in some lesions.Most lesions were enhanced with nodular,irregularly annular,beadlike or serpiginous shape.The diffusion of the most lesions was not significantly limited,and lesions showed equal or low signal on DWI.The NAA of lesions decreased in varying degrees,and Cho/NAA increased on MRS.The changes of the location and morphology of lesions were detected in four of five patients on the reexamination. Conclusion: The MRI manifestations of sparganosis have certain characteristics,and the enhanced manifestations are relatively specific.DWI,MRS and reexamination are very helpful for the definite diagnosis and differential diagnosis.MRI is of great significance in diagnosis and treatment of sparganosis,and provides a non-invasive and visual approach to further understand the pathological process of the lesion in vivo.

关 键 词：裂头蚴病 磁共振成像 扩散加权成像 磁共振波谱成像 病理学 

分 类 号：R532.3[医药卫生—内科学] R741.04[医药卫生—临床医学]