广州管圆线虫病误诊为过敏性脑炎1例

病例男性,60岁,突发双下肢麻木、乏力,伴大小便障碍10 d入院。10 d前突然出现双下肢麻木、乏力,伴双下肢肌肉酸痛,尚可缓慢行走,远端重于近端,同时出现解大小便困难。就诊于当地医院,给予静滴地塞米松5 mg/d治疗,5 d后症状未有明显好转,转诊我院。既往史:发病前3 d因“肾结石”自服中药治疗(具体不详);1 d后出现前胸及后背部皮疹、瘙痒,于当地医院治疗后症状缓解。入院查体:体温36℃,血压144/96 mm Hg。左肾区叩痛,     

广州管圆线虫病的胸部CT表现

目的 探讨广州管圆线虫病的胸部ＣＴ表现。方法 分析１２例经临床及血清学检查证实的广州管圆线虫病的胸部ＣＴ所见,所有病例均作胸部平扫,在病灶区增加层厚２ｍｍ、间隔２ｍｍ的薄层扫描。结果 １２例ＣＴ片上均显示有异常病灶。包括小结节病灶１０例,其中８例小结节周缘见磨玻璃样密度的“小结节月晕征”;小斑片磨玻璃样浸润灶例;外带部支气管血管束呈“Ｙ”形增粗３例。病灶具有两肺周边部散在分布的特点。结论 广州管圆     

广州管圆线虫病的影像学表现

广州管圆线虫病（angiostrongylus antonensis）是血管圆线虫属的一种寄生虫引起的人畜共患病，1935年我国陈心陶教授首先在广州褐家鼠的肺动脉中检出病原体。该病好发于热带、亚热带地区，以太平洋岛屿及东南亚地区为主，现在已在其他地区有病例报道。     

胶质母细胞瘤误诊为广州管圆线虫感染1例

患者男,52岁。因头痛5年余,加重9个月入院。患者反复出现左侧颞顶枕处隐约胀痛,每次持续10min左右,按揉后症状缓解。近9个月自觉头痛程度加重,发作频繁,每次持续2~3h,头部位置变动、起身活动或遇冷风后症状加重,伴昏沉感,除此患者无其它阳性症状和体征。患者有饲养仓鼠,并被咬伤病史。     

磁共振弥散张量成像在中枢神经系统的应用研究进展

磁共振弥散张量成像（MR-DTI）是一种新的无创性成像方法,它不同于常规T2加权成像和弥散加权成像（DWI）,它可以准确地反映水分子扩散的方向信息,并通过特殊的软件处理,能够实现白质的纤维跟踪与可视化,目前已经成为中枢神经系统临床应用和生命科学研究重要的工具,本文在近年来的文献基础上详述了弥散张量成像的基本原理,并对弥散张量成像在中枢神经系统各个方面的运用现状和研究进展做一综述。     

磁化传递技术在中枢神经系统磁共振成像中的应用

磁化传递技术在中枢神经系统磁共振成像中的应用倪红艳张文波祁吉李鹏张华宁磁化传递（ｍａｇｎｅｔｉｚａｔｉｏｎｔｒａｎｓｆｅｒ，ＭＴ）是一种较新的磁共振技术，该技术在常规激励脉冲之前预先使用频率偏离水质子共振频率的低能量射频脉冲，选择性地饱和大分子质子池...     

原发性中枢神经系统淋巴瘤的磁共振成像表现

目的探讨原发性中枢神经系统淋巴瘤（PCNSL）的磁共振成像（MRI）特征及鉴别诊断。方法回顾性分析15例经手术病理证实的PCNSL的MRI表现。结果病理检查均为B细胞来源的弥漫性大B细胞性淋巴瘤。15例PCNSL19个病灶,单发13例（87％）,多发2例（13％）共6个病灶。病灶常位于脑表浅部位和近中线部位,T1wI呈等或稍低信号,T2WI及液体衰减反转恢复序列（FLAIR）呈等或稍高信号,弥散加权成像（DWI）呈高信号。所有病灶均明显强化,增强后病灶大多呈均匀实质团块状或结节状强化,典型的可出现“尖角征”、“握拳征”,3例可见小囊变,呈“硬环征”。结论PCNSL的MRI表现具有一定的特征性,术前MRI检查有助于诊断及鉴别诊断,结合患者影像学及临床资料,术前可作出明确诊断。     

锰增强磁共振功能成像在中枢神经系统的研究

功能磁共振成像(fMRI)是近十余年来在传统的磁共振技术的基础上迅速发展起来的一种新的成像技术,与传统的磁共振成像技术不同的是,fMRI能够确定人脑在执行某项任务或受到某种刺激时大脑的哪些区域被激活。MR进行脑功能活动的研究主要有两种方法：一种是血氧水平依赖性成像(blood oxygen level dependent,BOLD);另一种是注药对比法,锰增强磁共振功能成像(manganese-enhanced functional MRI．ME-fMRI)就属于这种方法。     

小型凸面脑膜瘤颅骨受侵MRI特征探讨

目的分析小型凸面脑膜瘤侵犯颅骨的MRI表现特征,为制定手术方案提供准确信息。方法收集20例小型凸面脑膜瘤单纯颅骨受侵患者术前MRI资料进行分析。结果本组20例脑膜瘤肿块。术后病理分型为纤维型8例,血管瘤型3例,砂粒体型2例,过度细胞型2例,上皮型3例,微囊型2例。MRI上位于大脑凸面18例,矢状窦旁者2例。20例均有颅骨受侵,无瘤周水肿。结论小型凸面脑膜瘤颅骨侵袭的MRI表现具有一定特征性,即单纯颅骨内板增厚,瘤体组织呈结节状、蘑菇状、匍匐状侵及内板、板障,且沿板障侵袭性生长,可使颅骨骨质完全破坏,向颅外累及头皮。     

CT与磁共振成像在中枢神经系统神经母细胞瘤诊断中的价值及影像特征分析

目的 比较电子计算机断层扫描（CT）及磁共振成像（MRI）在中枢神经系统神经母细胞瘤诊断中的价值,并对其影像学特点进行分析。方法 回顾性选取遵义医科大学附属医院2018年1月至2022年12月期间所收治的疑似中枢神经系统神经母细胞瘤患者60例,所有患者行CT、MRI检查及病理组织活检。比较病理组织活检检查与CT检查、MRI检查方式的检出结果;比较CT检查、MRI检查的诊断效能;并分析相关影像学特征。结果 60例疑似疑似中枢神经系统神经母细胞瘤患者经病理组织活检检查后,确诊为阳性57例,阴性3例。CT检查诊断为阳性35例,阴性25例,其中仅有33例确诊为中枢神经系统神经母细胞瘤患者;MRI检查诊断为阳性48例,阴性12例,其中有47例确诊为中枢神经系统神经母细胞瘤患者;MRI检查的灵敏度、准确度均高于CT检查,差异有统计学意义（P<0.05）;但2种检查方式的特异度相比,差异无明显统计学意义（P>0.05）。结论 临床上应用CT、MRI均可有效检出中枢神经系统神经母细胞瘤患者的阳性情况,但其中MRI具有更高的灵敏度、准确度,临床上可根据患者自身情况选择相应的检查方式应用于患者...     

MRI findings of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis

AIM: To study the imaging characteristics of eosinophilic myelomeningoencephalitis due to Angiostrongylus cantonensis using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Seventeen MRI examinations of the brain and spinal cord in five patients with angiostrongyliasis cantonensis of the central nervous system were performed. The final diagnosis was based on typical clinical symptoms, results of blood and cerebrospinal fluid (CSF) tests, and the presence of nematode larvae in the CSF. The sequential MRI follow-up examinations were carried out at a different stage for every patient from 1 to 28 weeks after the onset of symptoms. The features of the lesions in the brain, spinal cord, meninges and nerve roots on MRI were studied, moreover, the development of the lesions was analysed on follow-up MRI. RESULTS: Abnormalities were demonstrated on MRI in all five cases. They included three cases of meningoencephalitis, one case of encephalitis and one myelomeningitis. The locations and appearances of the lesions were as follows: (1) brain involvement in four cases (including cerebrum in four, cerebellum in two and brain stem in three), and spinal cord involvement in one case. These lesions were diffuse or scattered and appeared as similar or slightly reduced signal intensity on T1-weighted images (T1WI), high signal intensity on T2-weighted images (T2WI) and turbo fluid attenuated inversion recovery pulse sequence (FLAIR) images. After administration of gadolinium chelate (Gd-DTPA), multiple round or oval enhancing nodules, with diameters ranging from 3 to 10 mm, were seen on T1WI, a few lesions appeared as stick-shaped enhancement whose longest measurement was 14 mm. Diffuse or local oedema around the lesion could be seen. (2) Meningeal involvement in four cases, a case of ependymal involvement and a case of nerve root involvement were among them. These lesions appeared as linear or nodular enhancement of the leptomeninges and ependyma, as well as nerve root enhancement. (3) There was a mild ventricular enlargement in two cases. On follow-up MRI lesions were most severe from the 5th week to the 8th week and it took at least 4-8 weeks (1-2 months) for a lesion to resolve completely, the resolution of larger lesion needed more than 22 weeks. CONCLUSION: Multiple enhancing nodules in the brain and linear enhancement in the leptomeninges were the main features; stick-shaped enhancement was the characteristic sign of the disease on Gd-DTPA enhanced-T1 weighted images.     

Lung CT findings of angiostrongyliasis cantonensis caused by Angiostrongylus cantonensis

Angiostrongyliasis cantonensis is a parasitic disease caused by human infection with Angiostrongylus cantonensis. Fifteen cases were enrolled in our study. Chest CT scanning was performed with MSCT in all cases. The chest CT images demonstrated that pulmonary nodular lesions and ground-glass opacity lesions located in the subpleural area are the characteristic signs of the disease. With the development of the disease, ground-glass opacity lesions disappear and pleural indentation occurs.     

中枢神经系统血管周细胞瘤的MRI诊断

目的：探讨MRI诊断中枢神经系统血管周细胞瘤（HPC）的价值,提高对本病的认识。方法：分析7例经手术病理证实为HPC的MRI表现。所有患者均行MRI平扫及增强扫描。结果：6例位于颅内,1例位于颈段椎管内。T1WI示肿瘤呈等信号或稍高信号,T2WI呈等信号或稍高信号,增强扫描肿瘤实体部分强化明显。在颅内病例中,4例病灶内有斑片状囊变或坏死区;4例显示有血管流空或强化血管影;5例有瘤周水肿;2例病灶部分跨过天幕。结论：中枢神经系统HPC的MRI表现有一定的特征,有一定的提示诊断,但需与脑膜瘤鉴别,要注意分析其恶性征象,以提高术前诊断的正确率。     

MRI在胎儿中枢神经系统中的临床应用

目的探讨MRI在胎儿中枢神经系统发育异常中的应用价值。方法24例孕妇，年龄25～34岁，平均28岁；孕龄20～39周，平均30周。产前例行超声检查后24h内行MR检查，T2WI采用半傅立叶单激励快速自旋回波(HASTE)快速扫描序列，T1WI采用二维快速小角度激励(FLASH)序列。将超声、MRI结果与出生后或引产后随访结果对照。结果24例孕妇共检出胎儿24个。MR T2WI可清楚、直观地显示出大脑实质、脑回、脑沟裂、胼胝体、丘脑、小脑、脑干及脊髓等解剖结构，T1WI质量差于T2WI。超声共显示病灶27个，MRI显示31个。MRI证实超声怀疑的诊断2例，进一步完善诊断10例，与超声诊断一致12例。结论MRI对胎儿中枢神经系统解剖结构的显示优于超声，而且不受孕妇体型、羊水量多少、胎儿颅骨及母体骨盆骨骼影响。在超声检查基础上进行胎儿MR检查，有助于弥补超声的不足，甚至更正超声诊断，可作为产前胎儿检查的辅助措施。     

原发性中枢神经系统淋巴瘤的MRI诊断

目的 研究原发性中枢神经系统淋巴瘤(PCNSL)的MRI表现特点,提高对该病的诊断与鉴别诊断率.方法 回顾分析了12例经病理证实的原发性中枢神经系统淋巴瘤的MRI表现.结果 病灶T1WI多呈略低或等信号,T2WI呈等或略高信号;增强扫描多呈明显均匀强化,极少数呈环形强化,肿瘤坏死囊变少见,未见出血、钙化;瘤周水肿相对较轻,占位效应轻.结论 原发性中枢神经系统淋巴瘤MRI表现具有一定特征性,可做出较准确的诊断.     

MRI in central nervous system infections: A simplified patterned approach

Recognition and characterization of central nervous system infections poses a formidable challenge to the neuro-radiologist. Imaging plays a vital role, the lesions typically being relatively inaccessible to tisue sampling. The results of an accurate diagnosis are endlessly rewarding, given the availability of excellent pharmacological regimen. The availability of numerous magnetic resonance (MR) sequences which provide functional and molecular information is a powerful tool in the hands of the radiologist. However, the plethora of sequences and the possibilities on each sequence is also intimidating, and often confusing as well as time consuming. While a large number of reviews have already described in detail the possible imaging findings in each infection, we intend to classify infections based on their imaging characteristics. In this review we describe an algorithm for first classifying the imaging findings into patterns based on basic MR sequences (T1, T2 and enhancement pattern with Gadolinium), and then sub-classify them based on more advanced molecular and functional sequences (Diffusion, Perfusion, Susceptibility imaging, MR Spectroscopy). This patterned approach is intended as a guide to radiologists in-training and in-practice for quickly narrowing their list of differentials when faced with a clinical challenge. The entire content of the article has also been summarised in the form of flow-charts for the purpose of quick reference.     

中枢神经系统血管母细胞瘤的MRI诊断

目的:探讨MRI(常规及DWI等序列)在中枢神经系统血管母细胞瘤诊断中的应用价值。方法:对经手术病理证实的73例血管母细胞瘤共81枚病灶的MRI表现进行回顾性分析。结果:血管母细胞瘤多为单发(67/73),小脑为最常见发病部位(61/81),可分为3型:囊伴结节型53个,实质型22个,单纯囊型6个;DWI序列肿瘤结节及实质型瘤体均呈低信号;19个病灶表现有囊中囊征象。结论:血管母细胞瘤的MRI表现具有特征性,且与其病理基础密切相关,能为手术方式的选择提供依据。     

原发性中枢神经系统淋巴瘤MRI表现分析

目的探讨原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)的MRI表现,提高诊断水平。方法回顾性分析我院经病理证实的14例PCNSL患者的MRI资料。14例患者均进行MRI平扫及增强扫描,其中3例患者行MRS。由两名资深MRI诊断医师对MRI图像进行分析,包括病灶的部位、数目、信号特点、强化方式、瘤周水肿、囊变坏死、出血及MRS等。结果1)病灶数目14例患者中单发12例,多发2例,单发病例中有2例病变跨越两个脑叶,1例病变位于左侧小脑半球-小脑蚓部;2)病灶分布右额叶5个,左额叶5个,左顶叶2个,胼胝体2个,左侧大脑脚1个,左侧基底节2个,左右颞叶各1个,左侧小脑半球2个;3)信号特点等T110个,稍长/长T19个;等T28个,稍长/长T211个;DWI稍高信号8个,高信号11个;4)强化特点不均匀强化3例,明显均匀强化11例,软脑膜强化3例,2例多发病例中所有病灶均明显均匀强化;5)瘤周水肿重度水肿2个,中度水肿3个,轻度水肿14个;6)出血及囊变出血2个,囊变2个。结论增强、弥散加权成像联合瘤周水肿对PCNSL的诊断有重要价值,MRS对鉴别诊断有一定的作用。     

中枢神经系统黑色素细胞肿瘤的MRI诊断

目的：探讨中枢神经系统黑色素细胞肿瘤的MRI特征。方法：回顾性分析16例经手术病理证实的中枢神经系统黑色素细胞肿瘤的临床资料及MRI资料,观察肿瘤MRI上的形态学特征及信号表现。结果：16例黑色素细胞肿瘤,男10例,女6例。年龄17～55岁。肿瘤位于颈段椎管内3例,额叶3例,颞叶2例,桥脑小脑角区1例,鞍区1例,小脑半球2例,脑内及脑膜多发者3例,全脑脊膜1例。肿瘤发生于颅底脑外者占17%,发生于近颅底脑实质者占43%。MRI信号特征典型者6例,不典型者10例,其表现为短T1等T2信号、或不均匀短T1等T2信号,或因瘤体卒中而呈囊实性混杂信号,增强扫描呈不均匀强化。结论：中枢神经系统黑色素细胞肿瘤可不具典型的MRI信号特征。对于发生于颅底及颈段软脊膜的有混杂T1或T2信号的肿瘤,在鉴别诊断时应考虑到该瘤的可能。     

中枢神经系统黑色素瘤的MRI表现

目的:探讨中枢神经系统黑色素瘤的影像表现,以期提高认识.方法:搜集经手术病理证实的中枢神经系统黑色素瘤8例,对其影像学表现进行分析.8例均行MRI平扫和增强扫描,7例行扩散加权成像(DWI)扫描,4例行氢质子磁共振波谱(1 H-MRS)扫描,2例行磁共振灌注(PWI)扫描.结果:8例患者原发2例,分别位于脑膜以及脊膜;转移6例,均位于脑内,多接近脑表面.信号表现:典型的黑色素瘤3例,T1WI呈高信号、T2WI呈低信号,增强扫描明显强化,不典型黑色素瘤5例,信号表现多样,部分出现囊变坏死,增强扫描实性部分明显强化.DWI示除2例多发转移者表现为低信号外,其余5例均表现为高信号或混杂高信号.1 H-MRS表现:原发于脑膜者胆碱(Cho)峰明显增高,N-乙酰天门冬氨酸(NAA)峰缺失,并出现高耸的脂质(Lip)峰;3例脑内单发转移者Cho峰明显升高,NAA峰减低,出现不同程度升高的Lip峰.PWI表现:2例行灌注成像者均表现为高灌注.结论:中枢神经系统黑色素细胞肿瘤影像表现多样,与其黑色素含量、瘤内出血及坏死密切相关,综合分析临床和影像资料有助于提高诊断的准确性.