脑脓肿壁的MRI特点及其与临床治疗的关系  

MRI characteristics of brain abscess wall and its relationship with clinical treatment

作　　者：王金林[1] 肖湘生[1] 施增儒[1] 丁学华[2] 卢亦成[2] 

机构地区：[1]第二军医大学长征医院影像诊断科,上海200003 [2]长征医院神经外科

出　　处：《第二军医大学学报》2003年第10期1137-1139,共3页Academic Journal of Second Military Medical University

基　　金：上海市卫生系统百名跨世纪优秀学科带头人培养计划基金(99XD14002);第二军医大学长征医院"208"优秀人才项目基金(98010).

摘　　要：目的:研究脑脓肿壁在MRI T1W、T2W及增强扫描上的影像特点及其与临床治疗的关系。方法:选择39例共43个脑脓肿,其中12例引流术前后MRI检查,并选择同期50例脑内肿瘤作对照。研究脓肿壁在MRI T1W和T2W上的信号特点及T1W、T2W和T1W强化前后壁的厚度比值并与肿瘤性囊壁相比较。结果:34个脑脓肿壁(79％)在T1W图像上为明显高信号,强化后厚度明显增加[(4.9±0.6)vs(2.1±0.3)mm,P<0.01]。9个在T1W上为等信号,强化后脓肿壁厚度基本相同(P>0.05)。对照组50例脑肿瘤囊壁在T1W和T2W的图像上为略低信号或等信号,强化前后壁厚度无差异。经引流及抗生素冲洗治疗后脓肿壁在T1W上的高信号均消失,强化前后厚度差异消失(P>0.05)。结论:T1W上的高信号基本为脑脓肿壁所特有,它不完全代表脑脓肿壁的肉芽组织,而是表示了炎性反应的影像学。Objective:To evaluate imaging features of MRI T1W,T2W and enhanced MRI in the wall of brain abscess and its relationship with clinical treatment. Methods: The signal intensity and thickness of the wall of brain abscess were studied in T1W, T2W and enhanced T1W MR images in 39 patients, of which 12 received MRI both pre- and post-drainage. And 50 patients with brain tumors were selected as control group. Results: The high signal intensity was noted in T1W images in 34 cases (79%, 34/43), in which the wall thickness increased after contrast (4. 9±0. 6 vs 2. 1 ± 0. 3,P<0. 01). The iso-intensi-ty of abscess wall was noted in 9 cases, in which the wall had no change on enhanced T1W MR images. The cystic wall of 50 cases had iso-intensity in T1W and T2W images and equal thickness after contrast. The high signal intensity in T1W images and difference of wall thickness disappeared after drainage. Conclusion: The high signal intensity is characteristic of abscess wall, and it indicates the inflammatory reaction other than granulomatous tissue.

关 键 词：脑脓肿壁 磁共振成像 治疗 诊断 MRI 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]