MRI-DWI联合Gd-DOTA增强在颅内结核影像分型的应用价值  

Application Value of MRI-DWI Combined with Gd-DOTA Enhancement in Imaging Classification of Intracranial Tuberculosis

作　　者：周洁[1] 陆召洋 蔡振[1] 王彩 韩典甫 Zhou Jie;Lu Zhaoyang;Cai Zhen;Wang Cai;Han Dianfu(Department of Medical Imaging,Zhongwu Hospital,Suqian,Jiangsu 223800)

机构地区：[1]宿迁市钟吾医院医学影像科,江苏宿迁223800

出　　处：《现代医用影像学》2023年第11期1981-1984,共4页Modern Medical Imageology

摘　　要：目的:分析MRI-DWI联合Gd-DOTA增强在颅内结核分型的应用价值。方法:回顾性分析2016年2月至2021年2月5年时间内,共39例临床明确诊断的脑结核患者为本次的研究对象。患者均接受磁共振平扫及增强检查,重点分析DWI序列和增强后T1FLAIR序列。结果:本组39例确诊结核病人的脑部磁共振Gd-DOTA增强后T1FLAIR序列发现病灶503个,全部呈现不同程度强化征象,DWI-MRI序列检出病灶175枚,DWI-MRI检出病灶和Gd-DOTA增强后阳性病灶存在一定非一致性(4%)。12例脑膜结核病人表现为单纯的脑膜呈斑片状、条片状及线样强化征;8例脑实质结核病人变现为颅内多发大小不等结节样强化影,其大小分布于0.5-28mm,大部分(85%)病灶小于10mm,部分病灶也呈现出环形强化改变;19例混合型颅内结核病人表现出脑膜和脑实质均有不同程度强化改变,具体表现与单纯脑膜强化和单纯脑实质病灶强化相仿。结论:MRI-DWI联合Gd-DOTA增强可对颅内结核进行准确分型。Objective:To analyze the application value of MRI-DWI combined with Gd-DOTA enhancement in the classification of intracranial tuberculosis.Methods:From February 2016 to February 2021,a total of 39 clinically diagnosed cerebral tuberculosis patients were retrospectively analyzed.All patients received MRI scan and enhanced examination,focusing on the analysis of DWI sequence and enhanced TIFLAIR sequence.Results:In this group of 39 patients with confirmed tuberculosis,503 lesions were found in TIFLAIR sequence after Gd-DOTA enhancement of brain magnetic resonance,all of which showed different degrees of enhancement.DWI-MRI sequence detected 175 lesions,DWIMRI detected lesions and Gd There was some inconsistency(4%)in the positive lesions after DOTA enhancement.12 patients with meningeal tuberculosis showed simple patchy,strip-like and line-like enhancement signs of the meninges;8 patients with brain parenchyma tuberculosis showed multiple intracranial nodular enhancements of varying sizes,the size of which was distributed between 0.5 and 0.5-28mm,most(85%)lesions were smaller than 10mm,and some lesions also showed annular enhancement changes;19 patients with mixed intracranial tuberculosis showed different degrees of enhancement changes in the meninges and brain parenchyma.Brain parenchymal lesions were similarly enhanced.Conclusion:MRI-DWI combined with Gd-DOTA enhancement can accurately classify intracranial tuberculosis.

关 键 词：结核 弥散成像 磁共振成像 分型 

分 类 号：R445.2[医药卫生—影像医学与核医学] R529.3[医药卫生—诊断学]