脑血吸虫病的MRI诊断

目的探讨脑血吸虫病的MRI表现及特征，提高对本病定性诊断水平。方法回顾性分析我院诊治的12例经临床和/或手术病理证实的脑血吸虫病患者的MRI资料。结果所有病例均行MRI平扫及增强扫描。12例中11例病灶位于大脑半球，1例位于小脑。MRI平扫时11例病变区内可见多发结节影，呈等或稍长T1，稍长或等T2信号，1例病变区内有班片状出血，T1及T2像均为高信号；1例为单发大结节，呈长T1及长T2信号，结节周边均有大片状呈长T1及长T2信号的水肿带。MRI增强扫描后11例病灶呈多发的结节状强化，部分小结节互相融合成较大结节，1例单发大结节增强后呈不均匀环状强化，强化程度在注射Gd-DTPA后40s、6min及12min时无明显差异；有8例病变区域内有班点状、班片状及泥沙样强化。结论脑血吸虫的MRI征象具有一定的特征性，结合临床资料和实验室检查，可以对本病作出准确的诊断。

Diagnosis of schistosomiasis in brain using MRI

Objective To probe imaging characteristics of cerebral schistosomiasis on MRI, improving qualitative diagnosis of it. Methods 12 patients that had been proven cerebral schistosomiasis pathologically and/or clinically were retrospectively reviewed. All 12 patients underwent plain and enhanced scan. Results 11 cases had lesions situated in cerebral hemisphere, 1 in cerebellum. On plain scan images, 11 cases showed multiple nodules with low or slightly long T1, slightly long or equal T2 signal, 1 case had patch- like hemorrhage with hyperintensity in T1 and T2. 1 case showed single big nodule showing long T1 and long T2 signal. Around the nodule was an edema belt with long T1 and long T2 signal. On enhanced scan images, 11 cases showed multiple nodular enhance- ment and some small nodules fused into a big one; 1 case that was a single big nodule was unevenly enhanced in the form of ring-shaped enhancement, and the enhancement degree changed little posterior to administration of GD-DTPA at 40 second, 6 minute and 12 minute, 8 cases showed spot-like, plaque-like or sand-like enhancement. Conclusion : MRI findings in cerebral schistosomiasis are characteristic, helping to make diagnosis in combination with clinical data and lab test.