脑型肺吸虫病的MRI表现

目的 :探讨脑型肺吸虫病的MRI表现特征及其诊断价值。方法 :搜集 3例经临床治疗和手术病理证实的病例 ,回顾性分析MRI影像表现特征及其与肺吸虫病发病机制的关系。 3例均行常规SE序列MRI扫描 ,1例复查扫描共计 3次 ,1例行Gd DTPA增强扫描。结果 :3例患儿发病年龄为 6～ 9岁 ,肺吸虫抗原皮下试验均为强阳性。所有扫描病例共计 14个病灶 ,10个病灶位于大脑 ,4个位于脑干和小脑部位。MRI表现为囊状和片絮状长T1长T2 信号 ,囊状病变囊壁呈短T1短T2 出血信号 ,1例显示特征性的“隧道征”。增强扫描有一定的意义 ,可显示囊壁无出血的病灶。结论 :脑型肺吸虫病多发生于儿童 ,MR表现相对较为典型 ,出血信号及“隧道征”具有特征性 ,MRI诊断该病具有重要价值。

MRI appearance of cerebral paragonimiasis

Objective:To study the MRI features of cerebral paragonimiasis and to assess the value of MRI in diagnosis of this disease.Methods:MRI features in 3 cases between 6 and 9 years old with cerebral paragonimiasis were analysed retrospectively. All the cases were proved by effective therapy and pathology.Conventional MRI was performed by using spin echo pulse sequences in 3 cases and Gd-DTPA enhancement was used in one case. Follow up scans were performed in 1 case by 2 times.Results:All 3 cases had 14 lesions totally,most of them located in cerebrum and cerebellum.MRI revealed conglomerated round cysts and edematous area, the cysts had high signal rim on T 1WI,caused by hemorrhagic changes.The characteristic appearance was "tunnel sign" in one case which showed the migrating track of adult worm.Gd-DTPA enhancement could show the lesion which was not detected in the early stage without hemorrhage. Conclusion:MRI features of cerebral paragonimiasis are relatively typical,the signal due to hemorrhage and "tunnel sign" are characteristic and differ from other cerebral diseases.