结核性脑膜炎的MRI诊断价值

目的 探讨MRI对结核性脑膜炎的临床诊断价值。方法 回顾性分析46例结核性脑膜炎患者的MRI表现。在46例结核性脑膜炎患者中，男29例，女17例，年龄11－72岁，平均年龄41.5岁，全部行MRI检查。结果 MR平扫可发现20例位于基底池的脑膜病灶；增强扫描有38例脑膜异常强化，伴脑膜、脑内粟粒型结核灶21例、结核性室管膜炎6例及颅神经受损2例。8例轻度脑膜炎患者无脑膜异常强化。复查9例中脑内病灶有不同程度好转或无改变。结论 MRI能清楚地显示结核性脑膜炎的各种病理改变、具有特征性表现，为临床诊断和观察疗效提供了可靠依据。MR扫描，特别是增强扫描是评价结核性脑膜炎的最佳手段。

The diagnostic value of MRI in tuberculous meningitis

Objective To evaluate the value of magnetic resonance imaging(MRI) in clinical diagnosis of tuberculous meningitis. Methods Forty six patients (29 men, 17 women, age ranged 11-72, mean age 41.5) with tuberculous meningitis were examined with MRI. The MRI findings of tuberculous meningitis were analyzed retrospectively. Results On pre contrast T 1WI and T 2WI, meningeal lesions in the basal cistern region were detected in twenty cases. Abnormal meningeal thickening and enhancement were found in 38 patients. Meningeal and cerebral miliary tuberculous foci were demonstrated in 21 cases. Ependymal involvement was found in six patients and cranial nerves were affected in other two patients. No abnormal meningeal enhancement was detected in eight mild cases. On the follow up images in nine patients, the abnormal findings alleviated in varied degree or, remained unchanged. Conclusion The pathological changes in tuberculous meningitis could be demonstrated effectively by specific findings on MRI. MRI, especially the post contrast MRI, proved a reliable modality in clinical diagnosis and assessment of tuberculous meningitis.