结核性脑膜炎的CT和MRI诊断及对比分析

目的 :对比研究 CT、MRI扫描对结核性脑膜炎 (简称结脑 )的诊断价值。方法 :5 0例经临床确诊的结脑患者 ,CT平扫和增强扫描 5 0例 ,MRI扫描 31例 ,其中 2 0例作了增强扫描。结果 :CT和 MRI平扫的敏感度分别为 72 %和 77.3% ;增强扫描的敏感度分别为 88%和 90 % ,平扫加增强扫描 CT、MRI的敏感度分别为 90 %和 90 .3%。影像表现为 :脑池及脑膜异常 ,脑积水 ,结核瘤 ,脑梗塞 ,脑炎 ,脑膜钙化 ,血管神经异常。结论 :CT和 MRI扫描对显示结脑较为特征性的脑膜病变和结脑的继发病变都有很高的敏感度。 CT和 MRI增强扫描的敏感度高于各自平扫。 MRI显示病变波及范围和继发病变优于 CT。

CT and MRI Diagnosis and Comparative analysis of Tuberculosis Meningitis

Objective:To investigate the value of CT and MRI in diagnosis of tuberculosis meningitis(TBM).Methods:50 patients were diagnosed as TBM by clinic.All cases were examined with plain CT and contrast enhanced CT.Among them,31 were examined with MRI and 20 with Gd-DTPA contrast enhanced.Results:In diagnosing the TBM,the sensitivity was 72% and 77.3% by CT and MRI respectively,the sensitivity was 88% and 90% by contrast enhanced CT and MRI respectively,while the sensitivity was 90%(45/50)and 90.3%(28/31) by combined with both CECT and MR respectively.Their abnormal imaging manifestation were:cisternal obliteration and meningeal abnormal enhancement,hydrocephalus,tuberculoma,ischemic infarct,cerebritis,meningitic calification,cranial vascular and nerve complications.Conclusion:The sensitivity of CT and MRI in showing the characteristic meningitic abnormal and the complications of TBM is high.The CE scans of CT and MRI are more sensitive than that of plain scans.MRI is more advanced than CT in showing the scope and complications of TBM.