脑膜与脑室结核的MRI表现

目的：通过分析脑膜结核和脑室结核的MRI表现，评估MRI对其诊断价值。方法：回顾性分析37例脑膜结核和脑室结核病例的MRI表现，特别是对其行钆喷酸葡胺（Gd-DTPA）增强扫描后的表现进行分析。结果：37例病例中，脑膜结核20例，脑室结核10例，脑膜结核伴脑室结核3例，脑膜结核伴脑结核4例。MRI平扫发现病灶20例，位于基底池的脑膜病灶14例，6例为室管膜病灶；增强扫描有25例脑膜异常强化，脑膜、脑内粟粒型结核灶14例，室管膜异常强化12例，伴脑室内肉芽肿3例，颅神经受损1例；22例发现并发症。结论：MRI能清楚显示结核性脑膜炎和脑室结核的病理改变，其MRI表现具有特征性，特别是MRI增强扫描是诊断脑膜结核和脑室结核的最佳影像手段。

MRI manitestations of meningeal tuberculosis and ventricular tuberculosis

Objective: To analyze the MRI findings of meningeal tuberculosis(MTB) and ventricular tuberculosis(VTB),and evaluate the usefulness of MRI in the diagnosis of patients with intracranial tuberculosis.Methods: The MRI appearances of 37 cases with MTB and VTB were reviwed,especially for Gd-DTPA enhanced MRI.Results: MTB in 20 cases,VTB in 10 cases,MTB with VTB in 3 cases,and MTB with cranial tuberculosis in 4 cases.The lesions were seen by MRI in 20 cases.In this cases,the lesion of basal cisterns in 14 cases,the lesion of ependyma in 6 cases.In contrast enhanced MRI,meningeal enhanced abnormally in 25 cases,14 patients with military lesion in the meninges and parenchyma,ependyma enhanced abnormally in 12 cases,including 3 patients with intraventricular granulomatous,cranial nerve lesion in one case.Conclusion: MRI can demonstrate the pathological changes of tuberculous meningitis and VTB apparently.The contrast enhanced MRI is the best way to diagnosis MTB and VTB.