【摘要】 目的探讨结核性脑膜炎的MRI表现及其与临床表现的相关性,提高对结核性脑膜炎的认识。方法回顾性分析42例结核性脑膜炎的临床和MRI资料,均经临床综合诊断确认。采用1.0T超导型磁共振成像仪,SE-T₁WI,T₂WI平扫,29例加增强扫描,17例完成临床早期和中晚期的不同阶段扫描。临床按病程和症状分为早和中晚期。结果 24例次完成早期检查,MRI显示异常5例（21%）,表现为脑膜轻度增厚（4例）或室管膜炎（1例）,呈T₁WI低信号、T₂WI高信号,丝网状强化;35例次完成中晚期MRI检查,33例显示异常（94%）,病变呈T₁WI低信号、T₂WI高信号;表现为单纯性脑膜明显增厚和/或室管膜炎19例,其中10例伴有邻近脑实质轻度水肿;粟粒性结节为主11例,单纯结核瘤5例,脓肿2例,呈斑块、结节样或环状强化,邻近水肿区相对较明显。结论结核性脑膜炎早期MRI检查阳性率低,表现较轻,中晚期MRI检查阳性率高,表现明显而多样。MRI增强检查有助于提高病变检出率。更多还原

【Abstract】 Objective To evaluate the relationship of clinical and magnetic resonance imaging（MRI）findings in patients with tubereulous meningitis（TBM）,and to improve the understanding of TBM.Methods The clinical and MRI findings in 42 patients with confirmed TBM were analyzed retrospectively.MRI examination was performed using a 1 Tesla system,including SE T₁WI and T₂WI. Intravenous contrast was injected in 29 patients,and follow-up scans were performed on 17 patients.Results Of 24 patients with early TBM,MRI was abnormal in 5（21%）with slight Tl-hypointense meningeal（4）or ependymal thickening（1）.MRI on 33/35（94%）patients with late stage TBM was abnormal with T₁ hypointensity and T₂ hyperintensity including meningeal thickening（19）,mild surrounding brain edema（10）,nodules（11）,tuberculoma（5）and abscess（2）.There was significant plaque-like,nodular or rim enhancement with surrounding brain edema.Conclusion Tuberculous meningitis has minimal clinical and MRI findings in the early phase and significant clinical and MRI findings in the late phase.The enhanced scan may help to detect the abnormality.更多还原