假瘤样炎性脱髓鞘病的 MRI 表现分析

目的：分析、总结假瘤样炎性脱髓鞘病（T IDD ）的M RI影像表现。方法回顾性分析10例经病理证实的 T IDD的M RI影像表现，10例均行M RI平扫及增强扫描。结果双侧额顶叶多发3例，单发7例，包括枕叶2例、基底节区2例、颈髓2例、左侧额顶叶1例。7例形态不规则，1例卵圆形，2例条带状。6例边界清楚，4例边缘模糊。单发病变直径1．7～5．6cm，平均（4．0±1．48） cm。8例瘤周轻度水肿，2例无水肿。长T1长T2信号8例，等T1长T2信号2例，FLAIR均呈高信号，3例DWI高信号，其中2例可见低信号区。3例可见出血。无囊变及钙化病例。增强扫描环形强化3例，不均匀明显强化2例，轻度强化及无强化各2例，1例半开环强化。结论 T IDD的M RI表现有一定特征，M RI具有较高的诊断价值。

MRI analysis of tumor-like inflammatory demyelinating diseases

Objective To analyse and summarize the MRI characteristics of tumor‐like inflammatory demyelinating diseases (TIDD) .Methods MRI findings of 10 cases with pathologically proved TIDD were analyzed retrospectively ,all patients received plain and enhanced MRI scan .Results 3 cases showed multiple lesions in bilateral frontal and parietal lobes ,and 7 cases showed soli‐tary mass ,in which 2 lesions located in the occipital lobe ,2 in the basal ganglia ,2 in the second to fifth segment of cervical cord ,and 1 lesion located in the left frontal parietal lobe .The shape of 7 lesions were irregular ,2 were stripped ,while 1 lesion was oval .6 cases had clear boundary ,while 4 showed ambiguous .Solitary lesions were 1 .7 cm -5 .6 cm in diameter(mean 4 .0 cm ± 1 .48 cm) .8 cases manifested mild edema while 2 had no edema .On MRI plain scan ,lesions were hypointensity on T1WI and hyperintensity on T2WI in 8 cases ,isointensity on T1 WI and hyperintensity on T2 WI in 2 cases ,and all lesions were hyperintensity on FLAIR sequence .DWI were performed in 3 cases ,all lesions showed hyperintensity ,2 of them had patchy hypointensity signal .Hemorrhage was detected in 3 lesions ,cystic lesions or calcification were not found in all cases .On post‐contrast scan ,3 lesions showed ring like enhancement ,2 showed obviously heterogeneous enhancement ,2 had mild enhancement and 2 cases had no enhancement ,1 presented with open ring like enhancement .Conclusion TIDD shows some specific MRI features ,and MRI is helpful to the diagnosis of TIDD .