脑血吸虫病的MRI诊断

目的 通过脑血吸虫病的MRI表现和手术后病理材料进行分析,探讨脑血吸虫病的MRI特征及其价值。方法 回顾性分析16例脑血吸虫病的MRI表现,并结合6例手术后病理材料进行比较。结果 11例（11／16）单发,5例（5／16）多发,共23个病灶。右侧大脑半球15个病灶（15／23）,其中额叶2个,额顶叶5个,枕顶叶8个;左侧大脑半球8个病灶（8／23）,其中额叶1个,额顶叶3个,枕顶叶4个。病灶与大脑灰质信号一致,周围为水肿环绕,呈岛状。其中12例（12／16）水肿形成“佛手征”。增强后15例（15／16）呈多个小结节状强化（直径1－3mm),呈簇状聚集成团。结论 脑血吸虫病的MRI表现具有特征性;MRI 临床诊断脑血吸虫病的最有价值的无创伤性检查手段。

MRI diagnosis of the cerebral schistosomiasis

Objective To discuss MRI appearance of the cerebral schistosomiasis and its clinical value through analyzing the MRI features and post surgery pathological findings. Methods MRI features of the cerebral schistosomiasis in 16,pathologically ( n =6) or clinically( n =10) proved cases were analyzed etrospectively,and compared with the post surgery pathological findings in 6 cases. Results Single masses were found in 11 cases (11/16),and multiple masses in 5 cases(5/16), amounting to 23 masses . fifteen masse(15/23) were located in right cerebral hemisphere,including frontal lobe ( n =2),frontoparietal lobe ( n =5) ,and occipitoparietal lobe ( n =8), while 8 masses (8/23) in left cerebral hemisphere,including frontal lobe ( n =1),frontoparietal lobe ( n =3), and occipitoparietal lobe ( n =4).The nodular masses were isointense with the gray mass like "island", and 12 cases (12/16) show the "gigantic hand" form of edma around them. After IV administration of Gd DTPA,15cases (15/16) revealed multiple closely spaced,intensely enhancing nodules,1 3 mm in diameter,distributed throughout the mass. Seven cases misdiagnosed by CT were revised by MRI. Conclusion The MRI appearance of the cerebral schistosomiasis is characteristic,and MRI is the most valuable tool to diagnose it without injury.