颅内结核病的MRI表现

目的：评价MRI对颅内结核病的诊断价值。方法：通过计算机病案管理系统检索近10年收治的颅内结核病病例21例，就其临床表现与MRI表现进行分析。结果：本组21例颅内结核病例中，脑膜型15例，脑实质型4例，另有2例为混合型，在MRI影像上脑膜型结核在T1权重像上均有脑池和脑裂的不规则信号增高，T2权重像上信号更高，但低于脑室内脑脊液信号，增强后均有脑膜的异常强化；脑实质型结核在T1权重像上呈等或稍低信号，T2权重像上为高信号，呈环状和结节状，增强后有均匀或不均匀强化，脑膜脑实质型结核具有上述两型的MRI表现，但主要以脑膜异常改变为著，结论：脑池，脑裂正常形态消失，呈T1稍低信号，T2高信号，但低于脑脊液信号，不规则的脑膜强化和脑实质内环状或结节状强化是颅内结核的主要MRI表现，对确立诊断有重要价值。

MRI FINDINGS OF INTRACRANIAL TUBERCULOSIS

ObjectiveTo evaluate the findings of intracranial tuberculosis.MethodsThe clinical and MRI manifestations of 21 cases of intracranial tuberculosis in our hospital during last 10 years are reviewed and analysised through CMRCS(Computer Medical Record Control System). ResultsAmong the 21 cases of intracranial tuberculosis, 15 cases are meningeal type, 4 cases are parenchymal type and the other 2 cases are mixed type. The meningeal type showed irregularly lowing signal of cistern and fissura on T1 weighted imaging and increasing signal on T2 weighted imaging which was lower than that in cistern. Meningeal imaging of this type enhanced abnormally after contrast. The parenchymal type showed equal or slightly low signal on T1 weighted imaging while high signal could be found on T2 weighted imaging. The signal appeared ring or nodular in shape, with homogeneous or heterogeneous enhancement after contrast. The MRI findings in the former two types could be found in the mixed type with the main abnormal changes in the meninges. ConclusionLosing of normal cistern or fissura conformation, slightly low signal on T1WI and high signal on T2WI (lower than that of cerebrospinal liquid) with irregularly enhanced meninges or ring and nodular shape enhanced signal in parenchyma are the most valuable MRI manifestations of intracranial tuberculosis.