脑囊虫病MR表现及病理分析

目的分析大宗脑囊虫病的MR表现,并探讨脑囊虫病的病理过程与影像对比.方法回顾性分析已确诊的脑囊虫病的MRI病例142例,每个病例都行轴位、矢状平扫及增强扫描.结果病灶显示:显示囊性病灶62%,其中显示囊性病灶周围伴水肿40%,只显示水肿信号30%,脑室内囊虫8%.脑囊虫分期:活虫期47例,变性死亡早期35例,变性死亡后期57例,钙化纤维化期3例.结论脑囊虫病MRI表现多种多样,主要取决于囊虫感染的不同阶段,mRI可以定性、定位诊断以及明确病理阶段.     

MRI对脑实质型脑囊虫病的诊断价值

目的探讨脑实质型脑囊虫病的MRI表现,提高对本病的诊断水平。方法回顾性分析已临床确诊的63例脑实质型脑囊虫病的脑MRI表现特点;所有病例均行SE序列T1WI、T2WI及FLAIR序列扫描,其中16例行增强扫描。结果活动期18例,变性死亡期37例,非活动期(钙化期)2例,混杂期6例,其中活动期均显示囊虫"头节"、变性死亡期均显示"白靶征"的脑实质型脑囊虫病的特征性MRI表现。63例患者中多发58例(占92.06%),单发5例(占7.94%),病灶主要位于双侧大小脑半球各叶皮层下。行增强扫描的16例强化程度不一,8例囊壁及头节均强化,7例仅有囊壁强化,1例无强化。结论脑实质型脑囊虫病具有特征性的MRI表现,能清楚显示病变在脑内的大小、范围、数目和部位,为临床诊断及治疗提供可靠的依据。     

脑囊虫病的影像学诊断

目的:探讨脑囊虫病的影像学诊断及鉴别诊断.方法:脑囊虫病患者60例经临床治疗及实验室检查确诊,对影像学表现进行回顾性分析.结果:按脑囊虫寄宿部位将脑囊虫病分为脑实质型51例、脑室型2例、脑膜型1例和混合型6例.结论:脑囊虫病CT、MRI表现多种多样,X线、CT、MRI是诊断脑囊虫病最常用的影像技术之一,可显示各型脑囊虫病改变,尤以非活动性脑囊虫病更佳.CT、MRI增强扫描可发现脑实质更多病灶.     

脑实质型脑囊虫病的病理改变与磁共振成象图象的对照观察

为探讨脑实质型脑囊虫病各期的病理改变及其磁共振成象(MRI)表现。对21例经临床、MRI及病理检查证实的脑实质型脑囊虫病患者进行了分析。其中活虫期13例,变性水肿期15例,肉芽肿期4例,钙化期2例。不同时期脑囊虫病的病理改变有不同的MRI表现,提示准确的MRI分期为临床治疗提供了有力的帮助。     

脑囊虫病MR诊断(附21例分析)

目的:分析探讨脑囊虫病的MR表现。方法:选取自2012年2月至2013年3月来我院就诊治疗的21例脑囊虫病患者临床资料进行回顾性分析,其中对21例脑囊虫病患者进行MR平扫,对9例患者进行增强扫描,并对MR征象进行分析,结合病理、血清试验协助诊断。结果:MR病灶显示存在四种不同变化:1.仅显示类圆形囊样变,主要为囊虫头节;2.囊虫头节变现不明显,仅病灶周围水肿明显,占位征象明显;3.多发斑点状低信号强度影,无占位病变;4.部分脑囊虫病可呈现环形强化、有的可出现点头状强化。结论:脑囊虫病的MR诊断是临床上诊断该病可靠科学有效的一种诊断方式,为临床分期提供重要依据,为临床分型、诊断及治疗方案提供重要线索,值得临床推广使用。     

MRI在脑实质型脑囊虫病诊断中的价值

目的 探讨MRI在脑实质型脑囊虫病诊断中的价值。方法 回顾性分析32例经临床、病理证实和MRI诊断的脑实质型囊虫病患者。全部病例在常规T1WI,T2WI扫描后均加扫了FLAIR序列,其中29例行增强扫描。分析其各期MRI征象及病理基础。结果 活虫期6例,退变死亡期20例(早期11例,晚期9例),非活动期2例,混杂期4例。MRI发现头节,是诊断脑实质型囊虫病的可靠依据,而MRI上"白靶征","多环、分层征"是脑实质型囊虫病的典型征象。结论 MRI多种序列的联合应用对脑实质型脑囊虫病可以给予定性、定位、定量诊断,同时MRI的准确分期为临床治疗方案的选择提供了有力帮助。     

脑囊虫病不同分期的MRI表现

目的:探讨脑囊虫病分型、分期的MRI表现特征。方法:回顾性分析40例脑囊虫病患者的MRI特点。结果:40例中脑实质型32例,脑室型2例,混合型6例,无1例单纯脑膜型;分期处于脑炎期者2例,存活期18例,变性死亡期20例,7例有钙化期表现。各期MRI表现不同。结论:MRI能反映脑囊虫病的病理学过程,其分型、分期对鉴别诊断及指导临床治疗有重要意义。     

脑囊虫病的MRI诊断及病理分析

目的 分析脑囊虫病的病理演变特点，探讨脑囊虫病的MRI特征及诊断价值。方法 分析36例脑囊虫病的MRI表现特点，并结合12例手术后病理材料进行比较。结果 脑实质型18例，脑室型4例，脑膜型3例，混合型11例，主要MRI特点：①囊虫存活期，病灶呈圆型，多发常见，附壁囊虫头节呈偏心型小点状影，T1WI呈略高信号，T2WI呈中低信号；囊液T1WI呈低信号，T2WI呈高信号；在FLAIR上脑脊液呈低信号，而囊液呈相对高信号；周围水肿不明显。②囊虫退变坏死期，头节消失，囊腔扩大，周围水肿明显。③病灶钙化后，T1WI及T2WI均呈低信号，周围水肿消失。④增强扫描，表现为：囊壁环状增强（24／36），或不增强（12／36）：囊内小点状影增强（22／36），或不增强（14／36）。⑤脑室型常发生于三、四脑室，其中三脑室1例（1／36），四脑室3例（3／36），均引起阻塞性脑积水。⑥脑膜型因蛛网膜粘连，而引起脑积水（2／36）。结论 脑囊虫病在病理演变过程中，具有特征性的MRI表现；MRI对确定脑囊虫病的数目、大小、部位等发病特点及病理演变过程具有很高的诊断价值。     

脑囊虫病26例MRI影像诊断分析

目的 评价MRI在脑囊虫病的诊断及分型、分期中的临床价值.方法 回顾分析26例脑囊虫病例的MRI影像学资料.结果 26例全部行MRI检查及增强扫描,脑实质型14例、脑室型4例、脑膜型3例、混合型5例;其中活动期9例,退变死亡期6例,非活动期4例,混杂期7例.结论 脑囊虫病MRI图像表现典型,能够准确对脑囊虫病进行分型及分期.     

脑囊虫病不同分期的影像学表现

目的：探讨脑囊虫病不同分期、分型的影像学特征。方法：对我院收治的91例脑囊虫病患者的CT检查及MRI检查的特点进行回顾性的分析。结果：在91例脑囊虫病患者中,按照脑囊虫发生的部位分型：有71例患者为中脑实质型,有8例患者为脑室型,有11例患者为混合型,有1例患者为软脑膜炎型;按照脑囊虫的病理学分期：有24例患者处于脑囊虫活动期,有28例患者处于脑囊虫的退变死亡期,有4例患者处于脑囊虫的钙化期,有35例患者处于脑囊虫病的混合期。不同分期的该病患者其CT检查及MRI检查的影像学结果均不相同。结论：不同部位和不同活动期的脑囊虫病,在影像学中的表现均有不同表现,其分型和分期对该病的治疗有指导意义。     

经颅多普勒超声联合头颅MRI在结核性脑膜炎诊断中的应用

目的探究经颅多普勒超声(TCD)联合头颅磁共振成像(MRI)在结核性脑膜炎(TBM)诊断中的应用价值。方法回顾性分析2018年1月至2020年3月间收治106例确诊为TBM患者的临床资料,其中Ⅰ期(早期)、Ⅱ期(中期)、Ⅲ期(晚期)患者分别为33例、48例、25例,所有患者均进行TCD、MRI检查,TCD检查患者大脑中动脉收缩期峰流速(Vs)、舒张期末峰流速(Vd)、平均峰流速(Vm)、搏动指数(PI),MRI扫描检查病变情况,计算单一检查及联合检查的阳性检出率,评估联合诊断价值。结果 TCD检查结果显示,早期患者Vm、Vs、及PI均显著低于中晚期患者而Vd高于中晚期患者(P<0.05)。MRI扫描检查结果显示早期患者中脑部异常17例,其中脑实质结核12例、脑梗死3例、脑膜增厚2例;早晚期中脑部异常56例,其中脑实质结核29例、脑梗死17例、脑膜增厚及强化16例、脑水肿5例、脑积水14例,且脑梗死合并脑膜强化、合并脑积水、合并脑实质结核各5、6、2例,脑积水合并脑膜强化、合并脑实质结核各5、3例,脑实质结核合并脑膜强化4例。TCD联合MRI检查对TBM的总体阳性检出率为89.62%,显著高于MRI单一检查的总体阳性检出率(68.87%,P<0.05);TCD联合MRI检查各分期检出率显著高于MRI单一检查(P<0.05),且TCD联合MRI检查与MRI单一检查各分期之间异常检出率差异有统计学意义(P<0.05)。结论经颅多普勒超声联合头颅MRI可对结核性脑膜炎患者的病情进行良好诊断,可为临床诊断提供可靠依据。     

小脑蚓部寄生虫病的临床特点与MRI表现分析

目的探讨小脑蚓部寄生虫病的临床特点并分析患者主要MRI表现。方法选择我院2011年1月-2015年8月收治46例小脑蚓部寄生虫病患者进行研究,对患者年龄、临床症状等进行总结,并行头颅MRI检查,分析小脑蚓部寄生虫病不同分期的MRI表现。结果小脑蚓部寄生虫病临床特点:以癫痫为主要首发症状、饮食习惯不良、男性发病率高于女性、青壮年好发。MRI特点:散在单个寄生,病灶小、数量多、分布广,76.2%(35/46)的患者为多发病灶。46例患者中,共存期24例(52.2%)、退变死亡期9例(19.6%)、钙化期13例(28.32%)。MRI表现:(1)共存期多示单个圆形或卵圆形病灶,囊壁及头节不强化,囊内可见点状头节。T1低信号、头节点状高信号;T2高信号、头节点状低信号。(2)退变死亡期虫体增大、不规则,T1示囊虫壁不规则环状或结节状高信号、虫体及周围水肿区低信号;T2示虫体及周围水肿区为高信号、囊虫壁不规则环状或结节状低信号,形成寄生虫病特异性改变—靶型病灶。病灶呈结节状或不规则环状明显强化。(3)钙化期病灶表现为无信号或单个或多个点状低信号,无水肿带、增强无变化。结论小脑蚓部寄生虫病临床特点与MRI表现均具有较大特征性,二者结合往往可准确诊断。     

脊髓血管母细胞瘤的MRI诊断

目的 分析探讨脊髓血管母细胞瘤的MRI表现,提高该病的影像诊断水平。方法 回顾分析经临床、手术病理证实的15例脊髓血管母细胞瘤的临床特征及MRI表现。全部患者均行MRI平扫及增强扫描,分析其MRI影像学特征(主要包括部位、形态、大小、信号特点、有无流空血管、瘤周水肿以及脊髓空洞等)。结果 大囊小结节型3例(20%),实性结节型12例(80%);颈段9例(60%),胸段2例(13%),腰骶段4例(27%);单发13例(87%),多发2例(13%),其中1例合并VHL综合征(VHL)。6例(40%)肿瘤的最大径≥3 cm,其余肿瘤最大径均＜3 cm;10例(67%)肿瘤内部及周围见增粗、迂曲流空血管影,4例(27%)肿瘤继发脊髓空洞,6例(40%)肿瘤周围广泛脊髓水肿,5例(33%)肿瘤未见脊髓空洞及周围水肿改变,其中1例脊髓空洞合并脊髓水肿。结论 脊髓血管母细胞瘤的MRI表现具有一定的特征性,肿瘤内部及周围多见流空血管、增强以后显著强化,常伴发瘤周水肿或脊髓空洞。MRI对脊髓血管母细胞瘤的鉴别诊断和术前评估具有重要价值。     

微侵袭神经外科技术治疗脑猪囊虫病

目的：探讨脑猪囊虫病的临床、病理特征及外科处理的适应证,介绍采用CT脑立体定向、神经导航结合显微手术等微侵袭神经外科技术治疗脑猪囊虫病的经验与体会。方法：脑猪囊虫病患382例,采用CT脑立体定向技术定位376例,神经导航技术定位6例,行“钥匙孔”小范围开颅,在显微镜下切除所有病灶。结果：309例有癫痫症状,术后303例症状消失,6例症状减轻,需继续给予抗癫痫药物治疗,术前有偏瘫51例,失语23例患,均于术后1mo内完全恢复,未出现新的神经损害症状,无并发症及死亡。结论：微侵袭神经外科技术是一种安全可靠、创造很小的方法,用于治疗脑猪囊虫病可取得满意疗效。     

侵袭性血管黏液瘤CT与MRI影像学特征性的研究

目的 总结分析侵袭性血管黏液瘤(AAM)的CT及MRI影像学特点，提高其诊断能力。方法 收集本院病理证实为AAM患者3例(均为女性患者)，应用256iCT、3.0T MR平扫及增强扫描，并对病灶大小、位置、形态、密度与信号和强化方式进行总结分析。结果 3例AAM患者，病灶位于下腹、盆腔及会阴部；直径＞15cm 1例，直径3-7cm 2例；3例均边界清楚，钻孔样生长1例；CT平扫稍低密度3例，T2WI不均质稍高信号1例/高低混杂信号2例；出现囊变1例； T2WI及MR增强扫描呈现漩涡征2例；CT增强渐进性强化3例、分层样改变1例、小血管断面强化1例。结论 AAM具有一定影像特征性，T2WI及MR增强呈漩涡征、CT增强分层样及小血管断面强化改变，有助于提高对该病的诊断。     

Application of Gd-DTPA in diseases of the central nervous system.

Patients whose routine MRI were negative but were clinically highly suspected of having intra-cranial or intra-spinal canal space-occupying lesions, and those whose routine MRI were positive but presented difficulties in defining the contour or the nature of the lesion, or difficulty in distinguishing the lesion from the surrounding edema were selected for Gd-DTPA enhancement. Altogether there were 80 cases, in which 51 had intracranial lesions and 29 intraspinal canal lesions. In each patient, Gd-DTPA 0.06-0.1 mmol/kg was injected intravenously 5 minutes before imaging (pituitary microadenoma images were taken immediately and 10 minutes after injection). No patient had contrast media reaction or complications. In cases with hemorrhage, hematoma, edema, cyst and arteriovenous malformation, no marked enhancement was observed after contrast media injection. When difficulty in differential diagnosis between these lesions and tumors occurs, injection of Gd-DTPA is very helpful. Gd-DTPA enhancement is of great benefit in diagnosis of intracranial or intraspinal canal tumors in four ways. 1) It reveals lesions which can not be demonstrated or can not be demonstrated clearly before enhancement, including iso-intensity lesions and small lesions which comprised 13.7% of our cases. 11 cases with equivocal diagnoses before enhancement obtained unequivocal diagnoses after enhancement. 2) It differentiates the tumor from edema more definitely. 3) It helps to distinguish the nature of lesions. 4) It shortens examination time when the T2 weighted image procedure is omitted.

     

The value of MRI in the diagnosis and management of neurocysticercosis

The clinical manifestation of neurocysticercosis is quite protean and variable making it the 'great imitator' of almost any neurological disorder. In the last decade, developments in diagnostic imaging and effective anticysticercus drug therapy have changed the outlook of the disease. Two cases investigated with CT scan and MRI are reported here. One case was treated effectively with antihelminthic therapy. In both cases MRI was found to be much more sensitive than CT scan in picking up the multiple cystic lesions. In addition, 'protoscoleces' and 'differential ring enhancements' not apparent in CT scan were well shown in MRI hence enabling the demonstration of different activity stages. In the treated patient, repeat MRI showed degeneration of the cyst. These illustrate that MRI is superior to CT scan in both the diagnosis and management of the illness.     

中枢系统原始神经外胚层肿瘤的MRI表现和病理分析

目的探讨中枢系统(central nerves system,CNS)原始神经外胚层肿瘤(primitive neuroectodermal tumor,PNET)的MRI表现及其病理联系,以提高诊断的准确性。方法收集10例经病理证实的PNET的MRI资料,并结合病理结果进行回顾性分析。结果 10例均位于幕上,其中顶叶2例、额叶2例、颞顶叶2例、双侧枕顶叶1例、基底节1例、丘脑1例、松果体区1例。肿瘤体积多较大,平均直径为5.3cm,边界均较清晰,除松果体病灶外9例均伴不同程度占位效应,其中2例无水肿、4例伴轻度水肿、2例伴中度水肿、1例伴明显水肿。形态上8例呈类圆形、2例呈分叶状。9例呈实性肿瘤或偏实性肿瘤(瘤内有小的囊变)、1例呈囊实性,其中4例(40%)伴坏死囊变、3例(30%)伴出血、2例(20%)伴钙化;肿瘤实性部分MRI上多呈稍长T1、稍长T2信号,弥散加权成像(DWI)呈等高信号,坏死、囊变呈低密度或长T1、T2信号。增强后8例呈均匀或不均匀明显强化。结论 CNS,PNET好发于儿童和青少年,其MRI表现有一定的特征性,最后确诊依赖于病理。     

肺癌脑转移的MRI诊断分析

目的 分析肺癌脑转移的MRI表现特征及诊断价值。方法 对82例经临床及病理证实为肺癌脑转移的患者行头部MRI检查，并进行回顾性分析。结果 82例肺癌脑转移患者中，腺癌52例，鳞癌13例，小细胞肺癌10例，肺泡癌2例。病灶增强后呈环形强化的21例，结节状强化的35例，混合型强化的17例，片状强化4例，单纯脑膜线状强化5例。结论 MRI增强扫描有助于肺癌脑转移的检出率，多发环形强化和（或）结节状强化病灶、瘤周明显水肿是其特征性表现．     

Alveolar echinococcosis: correlation of imaging type with PNM stage and diameter of lesions

Background  Although the computer tomography (CT) or magnetic resonance imaging (MRI) findings of alveolar echinococcosis (AE) have been well documented, the consecutive imaging changes of this disease in each PNM stage (parasite lesion, neighboring organ invasion, metastases) were not described accurately. The aim of this study was to analyze the correlation between imaging type and PNM stage and diameter of AE lesions, and to explore the development features of this disease.

Methods  A total of 87 patients with AE were examined using CT and MRI before medical management. Imaging features including the maximum diameter, calcification pattern, and imaging type of lesion were retrospectively assessed. The correlation of imaging type with PNM stage, diameter and calcification pattern was analyzed.

Results  Lesions (n=111) in 87 patients were divided into three types based on imaging characteristics; solid type (33.3%, 37/111, a solid lesion without liquid necrosis or only small patches of necrosis), mixed type (41.4%,46/111, solid component surrounding large and/or irregular liquid necrosis area), and pseudo-cystic type (25.2%,28/111, large cyst without visible solid component). Lesion calcification in the alveolar echinococcosis was categorized into three patterns; mild calcification (45.1%, 50/111, i.e. inconspicuous calcification or punctuate scattered calcification), moderate calcification (46.8%, 52/111, coastline calcification located at the periphery of the lesion, with or without the central dot-calcification) and abundant calcification (8.1%, 9/111, large calcified deposits). Significant differences were found between pseudo-cystic type and other two types in PNM stage, maximum diameter and calcification (P <0.05), but there was no significant difference between solid type and mixed type in those mentioned aspects (P >0.05). No correlation was observed between calcification patterns and maximum diameter (P >0.05).

Conclusions  Solid and mixed type lesions showed some similarities during the course of the disease and accounted for the major form of advanced AE. Pseudo-cystic type represented neither earlier nor advanced stage of AE, but a special presentation during AE development.