颅内结核瘤的MRI诊断

目的 通过分析３２例脑结核瘤的ＭＲＩ表现，讨论了脑结核瘤的鉴别诊断。方法 回顾性分析了３２例经手术、病理或临床随访证实为脑结核瘤患者的ＭＲＩ表现。全部病例均获取自旋回波Ｔ１ＷＩ、自旋回波或快速自旋回波Ｔ２ＷＩ及钆喷替酸葡甲胺（Ｇｄ－ＤＴＰＡ）增强Ｔ１ＷＩ。结果 全部病例ＭＲＩ平扫均发现病灶，单发２５例（包括脑膜结核瘤１例），多发７例（其中粟粒性脑结核瘤１例），除１例粟粒性外，３１例患者共发现４６个

MRimaging of intracranial tuberculomas

Objective To analyse the MRIfeatures of intracranial tuberculomas and to discuss the differential diagnosis- Methods 32 patients(16 malesand16females,4- 46 yearsofage,mean22 years) with clinically and pathologicalprovedintracranialtuberculomas werestudiedretrospectively- MRIstudies wereobtained on Siemens1-0TMRScanner- Spin echosequence T1 weightedimages,spin echoandfastspin echosequence T2weightedimages wereacquiredin allpatients- Axial ,sagitaland coronal T1 weighted imagas were obtained after IVadminitration of Gd DTPAin all patients- Results 7 patients had multiple lesions (including 1 miliary tuberculoma)- Theimmaturetuberculomas werehypointenserelativetobraingrey matteron T1 weightedimagesand hyperintense on T2 weighted images; after contrast administration the lesions showed homogeneous nodular enhancement- The mature tuberculomas with solid caseation appeared relatively hypointense orisointense on T1weightedimagesandisointenseto hypointenseon T2 weightedimages- The maturetuberculomas withliquid centre appeared centrally hypointense on T1 and hyperintense on T2 weightedimages with a peripheralhypointenserim on T2 weighted images- After contrast administration, the mature tuberculomas showed rim enhancement- ConclusionsThe diagnosisoftypicalintracranialtuberculomascanbe made with MRimaging- MRIcan detect more intracranialtuberculomasthan CTand can help make differentialdiagnosis-