CAJ | 학술논문

目的分析脑包虫病的MRI特征性表现.方法回顾性分析18例经手术病理证实脑包虫病患者的MRI表现,总结脑包虫病的MRI诊断与鉴别诊断要点.结果 18例脑包虫病患者中囊性包虫病和泡型包虫病各9例.囊性包虫病表现为脑内大小不等的圆形长T1、长T2信号病灶,内部信号均匀一致,液体衰减反转回复(FLAIR)序列扫描其内囊液信号可被抑制;DWI序列病灶为低信号;6例病灶周围无水肿带,3例破裂包虫囊肿病灶周围有水肿带;6例病灶见囊壁显示,3例病灶囊壁显示不明显;增强扫描3例破裂包虫囊肿有环形强化,6例病灶无强化;泡型包虫病表现为脑内多发等T1、短T2簇状异常信号,病灶周围通常有类似脑肿瘤样的水肿带.病灶T2WI信号似"煤炭样"黑色的低信号,内见无数密集稍高信号的小囊泡影,小囊泡直径约1～10 mm为其特征性表现.DWI序列病灶为低信号;Gd-DTPA增强扫描后病灶均见不规则的异常环形强化.2例脑灌注成像病变为低灌注改变.结论 MRI以多方位、多参数成像的优势显示脑包虫更准确,术前诊断率更高,对临床诊治具有重要意义.
목적 분석뇌포충병적MRI특정성표현.방법 회고성분석18례경수술병리증실뇌포충병환자적MRI표현,총결뇌포충병적MRI진단여감별진단요점.결과 18례뇌포충병환자중낭성포충병화포형포충병각9례.낭성포충병표현위뇌내대소불등적원형장T1、장T2신호병조,내부신호균균일치,액체쇠감반전회복(FLAIR)서렬소묘기내낭액신호가피억제;DWI서렬병조위저신호;6례병조주위무수종대,3례파렬포충낭종병조주위유수종대;6례병조견낭벽현시,3례병조낭벽현시불명현;증강소묘3례파렬포충낭종유배형강화,6례병조무강화;포형포충병표현위뇌내다발등T1、단T2족상이상신호,병조주위통상유유사뇌종류양적수종대.병조T2WI신호사"매탄양"흑색적저신호,내견무수밀집초고신호적소낭포영,소낭포직경약1～10 mm위기특정성표현.DWI서렬병조위저신호;Gd-DTPA증강소묘후병조균견불규칙적이상배형강화.2례뇌관주성상병변위저관주개변.결론 MRI이다방위、다삼수성상적우세현시뇌포충경준학,술전진단솔경고,대림상진치구유중요의의.
Objective To study the characteristic findings of brain echinococcosis on MRI. Methods The MRI findings of 18 patients with pathologically confirmed brain echinococcosis were retrospectively reviewed.Results Among the patients.there were 9 cases of cystic echinococcosis and 9 cases of alveolar echinococcosis.In cystic echinococeosis,MRI revealed homogeneously hypointensity on T1WI and hyperintensity on T2WI,while it showed low signal intensity inside the cysts on FLAJR and DWI. In 6 cases of cystic echinococcosis, no edema was detected surrounding the lesions,while edema resulting from cyst rupture was found in 3 cases.The cystic walls were visible in 6 csses, obscure in 3 cases.The ruptured hydatid cysts in 3 cases showed slight ring enhancement.Alveolar echinococcosis appeared as multiple lesions with isointensity on T1WI and hypointensity on T2WI,surrounded by vasogenic edema.The "charcoal-like"hypointensity and innumerous hyperintense bubbles of 1-10 mm in diameter inside the lesions on T2-weighted MR images were characteristic for lesions of alveolar echinococcosis.The lesions revealed hypointensity on DWI and showed irregular ring enhancement after injection of Gd-DTPA. Perfusion-weighted MR imaging revealed low relative cerebral blood volume.Conclusion MRI can demonstrate lesions of brain echinococcosis accurately due to its advantages of multiorientation and multiparameter.It is clinically valuable.