脑结核瘤的MRI诊断及其临床价值

目的：研究磁共振成像(MRI)对脑结核瘤的影像学诊断及其临床价值。方法：回顾性分析了12例经手术、病理或抗结核治疗随访证实为脑结核瘤病人的MRI及其临床资料。采用0．3T低场永磁型设备，行常规SET1WI、FSET2WI，其中11例行钆喷替酸葡甲胺(Gd-DTPA)增强扫描。10例行CT检查，其中6例行CT增强扫描。结果：本组12例共发现病灶32个，单发7例，多发5例，其中1例合并粟粒性结核瘤。将脑结核瘤的MRI表现不同分为2种类型。T1WI呈等或略高信号、T2WI呈等或略低信号，明显结节样强化或不均匀环状强化是脑结核瘤较具特征性的MRI表现，环内核心部分呈T2WI低信号对诊断更有价值。针对脑结核瘤的不同类型采取抗结核药物或手术切除等不同的治疗方法。结论：脑结核瘤有较特征性的删表现，并可指导临床采取不同的治疗方法。

MRI diagnosis and clinical value of cerebral tuberculomas

Objective:To investigate the MRI diagnosis and clinical value of cerebral tuberculomas.Methods:12 patients with clinically and pathologlcally prove cerebral tuberculomas were analysed retrospectively.MRI studies were performed on 0.3T low field MR scanner.Spin echo sequence T 1WI,fast spin echo (FSE) sequence T 2WI were acquired in all patients.Axial,sagittal and coronal SE T 1WI were obtained after administrating Gd DTPA in 11 cases.CT studies were performed in 10 patients with 6 cases contrast enhancement studies.Results:Altogether 32 lesions were found in all 12 patients.The 7 patients had single lesion, 5 patients had multiple lesions(including one military tuberculomas).MRI features were divided into two types:T 1 weighted imaging isointense or slightly hyperintense,T 2 weighted imaging isointense or slightly hypointense.Markedly nodular or heterogeneous ring like enhancing appearance of the lesions were characteristic of cerebral tuberculoma.T 2 weighted imaging hypointense in central core were more valuable for diagnosis of tuberculoma.Antituberculous drugs,surgery excision or both therapies were performed respectively according to different types.Conclusion:Cerebral tuberculomas have the characteristic MRI features.