结核性脑膜炎合并脑结核瘤MRI增强扫描的影像学特点及其诊断价值  

Diagnostic Value of MRI Contrast-enhanced in Tuberculous Meningitis Complicated with Brain Tuberculoma

作　　者：徐朝霞 毛丽 张小锐 张夏萌 高瑾 Xu Zhaoxia;Mao li;Zhang Xiaomi;Zhang Xiameng;Gao Jin(Department of Medicol Imdging,986 Hospital of Xijing Hospital,Air Fomo Medicol University,Xi'an,Shaanxi 710054)

机构地区：[1]空军军医大学西京医院986医院医学影像科,陕西西安710054

出　　处：《现代医用影像学》2022年第11期1991-1993,共3页Modern Medical Imageology

摘　　要：目的:探究结核性脑膜炎合并脑结核瘤在增强MRI上的表征及其诊断意义,进而提升对该疾病的认知。方法:回顾性分析经临床诊断的20例结核性脑膜炎合并脑结核瘤患者的MRI影像资料,所有患者均采用SE T1WI、FSE T2WI、FLAIR和Gd-DTPA增强扫描。结果:本研究特此以20例病人作为研究对象,针对他们的MRI图像展开检测与研究,直观看出,其发病位置基本位于环池、鞍上池、四叠体池、丘脑、基底节以及额颞叶区域,病灶多呈圆形、类圆形或花环状,表现为等长T1WI长T2WI信号改变,增强后病灶呈结节状、环状、斑片状、团块状强化。结论:MRI是诊断结核性脑膜炎合并脑结核瘤最有效的影像学方法,尤其是增强扫描能为本病的定性提供可靠依据,根据临床显示的治疗情况,结合实验室的测试结果,最终展开全面的讨论,能够尽可能增加正确的诊断率。Objective:To explore the features and diagnostic significance of tuberculous meningitis complicated with cerebral tuberculoma on enhanced MRI, so as to improve the cognition of the disease.Methods:The MRI data of 20 patients with clinically diagnosed tuberculous meningitis complicated with brain tuberculoma were retrospectively analyzed. All patients underwent SE T1 WI, FSE T2 WI, FLAIR and Gd-DTPA enhanced scanning.Results:In this study, 20 patients were taken as the research object, and their MRI images were examined and studied. It can be seen intuitively that the location of the disease was basically located in the cisterna annulata, suprasellar cistern, tetralogy cisterna, thalamus, basal ganglia and frontotemporal lobe. Most of the lesions were round, quasi-round or flower-ring, showing the signal changes of equal length T1 WI and long T2 WI. After enhancement, the lesions were nodular, annular, patchy and lumpy.Conclusion:MRI is the most effective imaging method for the diagnosis of tuberculous meningitis complicated with brain tuberculoma, especially enhanced scanning can provide reliable basis for the qualitative diagnosis of this disease. According to the clinical treatment and laboratory test results, a comprehensive discussion will finally be conducted, which can increase the correct diagnosis rate as much as possible.

关 键 词：结核性脑膜炎合并脑结核瘤 MRI 诊断 

分 类 号：R529.3[医药卫生—内科学] R445.2[医药卫生—临床医学] R742.9