CAJ | 학술논문

目的：分析31例颅内结核瘤的影像学资料，探讨其诊断和鉴别诊断。方法：回顾性分析31例经手术病理（17/31）和抗痨治疗随访（14/31）证实为颅内结核瘤的影像学表现。结果：平片示边缘光滑，密度不均的“蛋壳样”钙化。CT示单发或多发，等或混杂密度小结节影，多发病灶较小，病灶 0.5～5.5 cm；单发病灶偏大，（19/31）＞2 cm，周围水肿不明显。增强后呈结节状或环状强化。MRI显示T1WI为低或等信号，T2WI为低、等或高信号，（11/16）增强呈结节状强化，其余无强化。结论：典型的颅内结核瘤有特征性影像学表现，非典型病灶需与脑脓肿、脑囊虫、胶质瘤和转移瘤鉴别，必要时采用穿刺活检或手术病理确诊。强化抗痨治疗后复查CT、MRI可帮助鉴别，严格掌握手术适应证，可使病人免于手术治疗。
목적：분석31례로내결핵류적영상학자료，탐토기진단화감별진단。방법：회고성분석31례경수술병리（17/31）화항로치료수방（14/31）증실위로내결핵류적영상학표현。결과：평편시변연광활，밀도불균적“단각양”개화。CT시단발혹다발，등혹혼잡밀도소결절영，다발병조교소，병조 0.5～5.5 cm；단발병조편대，（19/31）＞2 cm，주위수종불명현。증강후정결절상혹배상강화。MRI현시T1WI위저혹등신호，T2WI위저、등혹고신호，（11/16）증강정결절상강화，기여무강화。결론：전형적로내결핵류유특정성영상학표현，비전형병조수여뇌농종、뇌낭충、효질류화전이류감별，필요시채용천자활검혹수술병리학진。강화항로치료후복사CT、MRI가방조감별，엄격장악수술괄응증，가사병인면우수술치료。
Objective:To analyse the imaging featrues of intractranial tuberculoma and improve the diagnostic accuracy.Methods:31 patients with clinical characteritics and pathological proved intracranial tuberculomas were studied retrospectively.Results:"egg-shell"calcification were the feature of giant calcified and ossified tuberculoma.CT scaning were single and multiple nodular lesion.In the contrast enhancing CT scaning,plate shaped or ring form shadows were shown.MRI were provided hypointense on T1WI and hyperintense on T2WI.The rim homogeneous enhancement were showd in the Gd-DTPA.Conclusion:The diagnosis of typical intracranial tuberculomas can be made.After antituberculosis chemotherapy,CT and MRI can help made differsntial diagnosis.Operative indications should be select strictly.