小儿结核性脑膜炎CT表现(附151例分析)

目的:评价CT扫描对小儿结核性脑膜炎的诊断价值。方法:151例经临床确诊的结核性脑膜炎患儿,CT平扫151例,增强78例,62例患儿复查2~5次。结果:CT正常21例,异常130例,其中脑积水128例,脑沟普遍增宽73例,脑底池闭塞密度增高85例,脑膜血管异常强化56例,脑梗塞54例,结核瘤26例,钙化22例。结论:CT在诊断小儿结核性脑膜炎中具有重要价值,脑沟增宽可作为脑萎缩早期的唯一征象,基底池变窄密度增高伴脑积水及局灶状脑梗塞为其典型表现,增强CT显示脑膜血管异常强化及结核瘤的敏感性明显高于平扫CT。

CT manifestation of tuberculous meningitis in children(analysis of 151 cases)

Objective: To evaluate the value of CT in the diagnosis of tuberculous meningitis (TBM) in children. Methods: 151 patients were diagnosed as TBM clinically, and were examined by plain CT in which 78 cases also had contrast enhanced CT. 62 cases were reexamined 2-5 times. Results: Twenty-one cases were normal on CT and 130 cases were abnormal. Among them, 128 had hydrocephalus, the cerebral sulcus appeared widen in 73 cases, the basilar cisterns of 85 cases were obliterated and with increased density, 56 had abnormal meningeal vasculatures, 54 had ischemic infarct, 26 had tuberculoma and 22 had calcification. Conclusion: The value of CT in diagnosing childhood tuberculous meningitis is very important. The cerebral sulcus appeared widened on CT can be the only sign in early stage. The obliteration and enhancement of the basilar cisterns followed by hydrocephalus and ischemic infarct are the typical manifestations. The sensitivity of contrast enhanced CT in showing characteristic abnormal meningeal vasculatures and tuberculoma is better than that of plain CT.