粟粒性脑结核的MRI诊断

目的：观察粟粒性脑结核的MRI征象,探讨MRI各序列对本病的诊断价值。方法：回顾性分析13例临床确诊并经抗结核治疗痊愈或有效的粟粒性脑结核患者的MRI和相关临床资料。全部病例均行MRI平扫及增强扫描,1例行DWI检查。结果：粟粒性脑结核多发生于大脑半球灰白质交界区,直径≤3mm。大部分结节T1WI呈等或稍低信号,T2WI及T2FLAIR呈稍高信号或中心＂靶征＂,伴不同程度灶周水肿,增强后呈小结节样或环形强化。部分早期未成熟结节平扫各序列均呈等信号,DWI亦无异常发现,无灶周水肿,仅增强扫描呈小结节样强化。结论：粟粒性脑结核的MRI表现具有一定特征,增强扫描可发现更多病灶,是必不可少的检查手段。

MRI diagnosis of cerebral miliary tuberculosis

Objective：To study the MRI features of cerebral miliary tuberculosis,and to investigate the diagnostic value of various MRI sequences.Methods：Of 13 patients with clinically diagnosed cerebral miliary tuberculosis and cured/improved after anti-tuberculosis treatment,their MRI materials were analyzed retrospectively.All of the patients had plain and enhanced MRI,one patient had DWI.Results：Most of the cerebral miliary tuberculosis lesions located at the junctional area of white and gray matter,with the diameter ≤3mm,showing iso-intensity or slight hypo-intensity on T1WI,slight hyper-intensity or target sign on T2WI and T2 FLAIR,accompanied with various degree of perifocal edema,nodular or ring-like enhancemant after contrast injection.Part of the early immature nodules showed iso-intensity in all sequences of plain MRI with neither abnormality on DWI nor perifocal edema,only tiny nodular enhancement could be revealed after contrast administration.Conclusion：Certain MRI characteristics of cerebral miliary tuberculosis could be revealed,more lesions could be displayed on enhanced images,which is indispensable for the diagnosis.