【摘要】 目的　研究中枢神经系统广州管圆线虫病的磁共振影像表现。方法　 5例经实验室检查和临床治疗证实的广州管圆线虫病患者共做头部及颈腰部MRI检查 17例次。MRI扫描仪为 0 5T超导装置。在MRI不同序列上观察脑、脊髓、脑脊膜和神经根有无病变及其分布、形态及信号表现 ,通过随访MRI检查 ,分析病变出现及消散、好转情况。结果　 5例患者MRI显示脑膜脑炎 3例 ,脑炎1例 ,脊髓脊膜炎 1例。具体病变部位及表现如下 :(1)脑实质受累 4例 ,脊髓 1例。这些病变呈弥漫或散在分布 ,在T1WI上呈稍低或等信号 ,在T2 WI和对应层面液体衰减反转恢复序列 (FLAIR)图像上呈高信号 ,注射钆喷替酸葡甲胺 (Gd DTPA)后病变中央可见圆形或卵圆形强化灶 ,最大直径 10mm。有时可见粗细不等的长条形强化 ,长达 14mm。强化灶周围可有小范围的低信号水肿区。 (2 )脑脊膜受累 4例 ,其中包括室管膜及神经根受累各 1例。注射Gd DTPA后表现为软脑膜或 (和 )室管膜呈线条形或结节状强化及神经根强化。 (3)轻度脑室扩张 2例。追踪动态观察提示 ,发病后第 5～ 8周是颅内病变最明显的时期 ,病变从发现至消退至少需要 8周时间。结论　中枢神经系统广州管圆线虫病的MRI表现多种多样。脑脊髓内多发长条形或结节状强化和软脑膜强化是本病主要的MRI表更多还原

【Abstract】 Objective To study the characteristics of eosinophilic myelomeningoencephalitis due to angiostrongylus cantonensis on MRI. Methods MRI examinations of the brain and spinal cord in 5 patients with angiostrongyliasis cantonensis in central nervous system were performed 17 times. The final diagnosis was based on typical clinical symptoms, results of blood and CSF tests, and the presence of nematode larvae in CSF. The sequential MRI follow up examinations were carried out for every patient in different stages after the ictus, then the features of the lesions on MR image in the brain, spinal cord, meninges and nerve roots were studied, moreover, the processes of their dynamic changes were analyzed as well. Results Abnormalities were demonstrated on MRI in all 5 cases. They included 3 cases of meningoencephalitis, 1 encephalitis and 1 myelomeningitis. The detailed locations and appearances of the lesions were as follows: (1) brain involvement in 4 cases (including cerebrum in 4, cerebellum in 2 and brain stem in 3 cases), spinal cord involvement in 1 case. These lesions were diffuse or scattering distribution and appeared as iso or slightly low signal intensity on T 1WI, high signal intensity on T 2WI and FLAIR images. After administration of Gd DTPA, multiple enhanced nodules in round or oval shape, with the diameter ranging from 3 mm to 10 mm, were showed on T 1WI, a few lesions appeared as stick like shaped enhancement whose longest measurement was 14 mm. The surrounding edema was limited. (2) meningeal involvement in 4 cases, a case of ependyma and a case of nerve roots involvements were among them. These lesions appeared as linear or nodular enhancement of the leptomeninge and the ependyma, as well as the nerve roots enhancement. (3) ventricular enlargement in 2 cases. The dynamic study based on follow up MRI suggested that above lesions were severest from 5 to 8 weeks after the ictus and may lasted for more than 28 weeks, their resolution needed at least 2 months. Conclusion MRI appearance of the disease was various. Multiple linear and nodular enhancement in the brain and spinal cord and enhancement in the leptomeninges were the main findings, stick like shaped enhancement was the characteristic sign on MRI.更多还原