头颅CT及MRI在结核性脑膜炎诊断中价值

目的总结分析结核性脑膜炎患者临床表现及CT和MRI影像特征,以期提高结核性脑膜炎诊治水平。方法回顾性分析37例结核性脑膜炎患者临床及头颅CT和MRI影像资料。结果本组患者26例行头颅CT检查,同时10例行MRI检查,11例直接行MRI检查;头颅CT平扫显示脑积水、脑梗死、单发或多发结核瘤、脑沟及脑裂池变窄、脑出血等异常改变17例,未显示异常者9例;21例行头颅MRI平扫显示,16例脑沟脑池狭窄和闭塞,邻近脑膜增厚,增强扫描显示受累脑膜呈线条状、点状、斑片状、环状或结节状强化,12例脑积水中4例为重度,10例脑梗死,8例结核瘤,未显示异常4例。结论头颅CT及MRI对结核性脑膜炎的诊断均有重要价值。

Value of cerebral CT and cerebral MRI to the diagnosis of tuberculous meningitis

Objective To improve the level of diagnosis and treatment of tuberculous meningitis by summarizing and analyzing the clinical manifestations and characteristics of CT and MRI.Methods The clinical data and cerebral CT and MRI characteristics were retrospectively analyzed in 37 cases of tuberculous meningitis.Results In these 37 cases,16 received only cerebral CT scanning,11 cases received only cerebral MRI scanning and 10 cases received both cerebral CT and MRI scanning.Cerebral CT plain scanning showed abnormal findings such as hydrocephalus,ischemic infarct,single or multiple tuberculomas,stenosis and occlusion of anfractuosity and sulcus,and cerebral hemorrhage in 17 cases,and the other 9 cases were found no abnormal changes.In 21 cases receiving MRI scanning,cerebral MRI plain scanning showed stenosis and occlusion of cerebral sulcus and cistern,and abnormal leptomeninges thickening,enhancement scanning showed enhancement in strip,flake,nodular or annular shapes after contrast injection in 16 cases,hydrocephalus in 12 cases including severe hydrocephalus 4 cases,ischemic infarction in 10 cases,tuberculomas in 8 cases,and no abnormal finding in 4 cases.Conclusion Cerebral CT and cerebral MRI play important roles in the diagnosis of the tuberculous meningitis.