结核性脑膜炎40例CT、MRI影像与临床分析

目的: 探讨结核性脑膜炎(TBM)的影像学表现与诊断、治疗和预后的关系。方法: 对40例结核性脑膜炎的头颅CT或MRI进行研究,并结合临床作回顾性分析。结果: 40例中,早期7例,中期17例,晚期16例。影像学表现为:脑池及脑膜异常、脑积水、结核瘤、脑梗死和脑膜钙化等。正规合理的抗结核治疗后,有效33例(82.5%),无效6例(15.0%),病死1例(2.5%)。结论: CT或MRI能较清楚地显示结核性脑膜炎的多种病理改变,具有特征性表现,结合临床有助于TBM的早期诊断、治疗方案的选择和预后的判断。

CT and MRI image and clinical analysis of tuberculous meningitis:A report of 40 cases

Objective:To analyze the relations between the imaging features of CT or MRI and the diagnosis,treatment and prognosis of tuberculous meningitis.Methods:The CT or MRI of 40 patients with tuberculous meningitis was analyzed retrospectively.Results:The imaging manifestations of the 40 cases of tuberculous meningitis (early stage 7,metaphase 17,and advanced stage 16) were cisternal obliteration and meningeal abnormal enhancement,hydrocephalus,tuberculoma,ischemic infarct,and meningitic calification.All the cases were treated by regular antituberculous drug therapy.Thirty-three(82.5%) cases improved,6 worsened(15.0%) and 1 died (2.5%). Conclusions:The pathological changes in tuberculous meningitis can be demonstrated effectively by specific findings on CT or MRI,which is beneficial to the early diagnosis,treatment and prognosis of tuberculous meningitis.