脑血吸虫性肉芽肿的影像征象分析
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[摘要] 目的：通过对脑血吸虫性肉芽肿的CT和MRI影像征象进行分析，探讨脑血吸虫性肉芽肿的CT和MRI特征及其价值。方法：回顾性分析经手术病理及临床证实的脑血吸虫性肉芽肿20例，采用GE公司生产的Hispead Dual螺旋CT机及XGY0.3T开放式永磁型MRI仪，分别进行平扫及增强扫描。结果：幕上大脑17例，幕下小脑3例。CT平扫病变呈等密度或稍高密度，MRI平扫T1WI大多呈等或稍低信号，T2WI呈高信号但低于脑脊液信号，液体衰减反转恢复序列呈稍高信号。CT和MRI增强表现为：脑皮质或皮层下区多发或单发大小不等的强化结节，呈簇状聚集成团。结论：脑血吸虫性肉芽肿的CT和MRI表现具有特征性，是临床诊断脑血吸虫性肉芽肿最有价值的检查手段。
[关键词] 血吸虫病；肉芽肿；脑；磁共振成像；体层摄影术；X线计算机
[中图分类号] R532.21[文献标识码]A [文章编号]1673-7210(2009)02(b)-014-02
The analysis of imaging signs of brain schistosomiasis granuloma
OUYANG Yi-ge, LI Bing-hua, QI Shao-lin, LEI Tie-jun
(Department of CT&MRI, Jinshi People's Hospital, Hunan Province, Jinshi415400, China)
[Abstract] Objective: To discuss CT and MRI characteristics of brain schistosomiasis granuloma and their clinical values by analyzing the imaging signs of brain schistosomiasis granuloma. Methods: 20 cases of brain schistosomiasis granuloma confirmed by operation and pathology and clinic diagnosis were retrospectively analyzed. Plain and enhanced CT were performed in all patients by the Hispead Dual scanner and XGY Signa profile 0.3 Tesla open scanner produced by GE company. Results: 17 cases were observed lesions located in supratentorial region and 3 cases were observed in infratentorial region. The nodules were isodense or slight hyperdense on CT plain scan, isodense or slight hypodense on T1WI, hyperdense on T2WI, slight hyperdense on FLAIR. CT and MRI enhancement presented as: multiple or single enhanced noduleswere shown at the cortical or subcortical area, distributed throughout the mass. Conclusion: The CT and MRI appearance of brain schistosomiasis granuloma is characteristic, and it is the most valuable tool to diagnose it.
[Key words] Schistosomiasis; Granuloma; Brain; Magnetic resonance imaging; Tomography; X-ray computed
脑血吸虫性肉芽肿是脑血吸虫病的常见类型。笔者收集2000～2006年具有完整影像及临床资料、并经病理和临床确诊的脑血吸虫性肉芽肿20例，对其CT和MRI表现作一回顾性分析，结合手术病理所见，对本病的影像表现特征作进一步探讨。
1 资料与方法
1.1 一般资料
本组20例，其中，男14例，女6例；年龄1～57岁，平均31.7岁。患者均来自我市及洞庭湖血吸虫流行区。首次出现症状至行CT和MRI检查时间1～17个月不等。主要临床症状为头痛、呕吐、癫痫，另外还有失语、偏瘫等。本组20例血清血吸虫免疫学检查结果均为阳性；13例有肝血吸虫病治疗史；15例经抗血吸虫治疗2～3个月后复查，原发病灶明显缩小或消失，症状缓解。4例经手术病理证实。
1.2 扫描方法
采用GE公司Hispead Dual螺旋CT机 ......
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