颅内结核瘤的影像学诊断

目的分析31例颅内结核瘤的影像学资料,探讨其诊断和鉴别诊断。方法回顾性分析31例经手术病理（17/31）和抗痨治疗随访（14/31）证实为颅内结核瘤的影像学表现。结果平片示边缘光滑,密度不均的“蛋壳样”钙化。CT示单发或多发,等或混杂密度小结节影,多发病灶较小,病灶0.5～5.5cm;单发病灶偏大,（19/31）＞2cm,周围水肿不明显。增强后呈结节状或环状强化。MRI显示T1WI为低或等信号,T2WI为低、等或高信号,（11/16）增强呈结节状强化,其余无强化。结论典型的颅内结核瘤有特征性影像学表现,非典型病灶需与脑脓肿、脑囊虫、胶质瘤和转移瘤鉴别,必要时采用穿刺活检或手术病理确诊。强化抗痨治疗后复查CT、MRI可帮助鉴别,严格掌握手术适应证,可使病人免于手术治疗。

Imaging Diagnosis of Intracranial Tuberculoma

Objective:To analyse the imaging featrues of intractranial tuberculoma and improve the diagnostic accuracy.Methods:31 patients with clinical characteritics and pathological proved intracranial tuberculomas were studied retrospectively.Results:"egg-shell"calcification were the feature of giant calcified and ossified tuberculoma.CT scaning were single and multiple nodular lesion.In the contrast enhancing CT scaning,plate shaped or ring form shadows were shown.MRI were provided hypointense on T 1WI and hyperintense on T 2WI.The rim homogeneous enhancement were showd in the Gd-DTPA.Conclusion:The diagnosis of typical intracranial tuberculomas can be made.After antituberculosis chemotherapy,CT and MRI can help made differsntial diagnosis.Operative indications should be select strictly.