颅内真菌感染的CT和MRI表现(1)
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[摘要] 目的:分析颅内真菌感染的CT及MRI表现,提高其影像学诊断准确率。方法:本组资料中,经病原学证实颅内真菌感染7例,真菌性肉芽肿或脓肿5例,单发1例,多发4例,同时累及脑膜3例,真菌性脑膜炎2例。结果:真菌性脑膜炎广泛累及基底池、大脑凸面脑膜,CT表现为基底池密度增高,脑沟回变浅,增强铸型强化;真菌性肉芽肿或脓肿多发病灶,体积较小,单发病灶部位深在,CT上多呈混杂密度,增强脓肿壁多呈不规则、不连续性厚壁环,表现为“开环征”;MRI在T1WI上呈等低信号,T2WI信号变化较大,略低信号为特征表现,增强多为不规则强化,局部可伴硬膜外脓肿及硬脑膜或蛛网膜强化。结论:颅内真菌性肉芽肿有一定的CT和MR表现特点,“开环征”、T2WI略低信号为其特征表现。真菌性脑膜炎虽有典型铸型强化,但难与结核性脑膜炎鉴别。
[关键词] 真菌感染;肉芽肿;X线计算机体层摄影;磁共振成像
[中图分类号] R739.41[文献标识码] B [文章编号]1673-7210(2010)06(b)-066-03
The CT and MRI manifestations of intracranial fungal infection
CHEN Yonghua1, HE Yulin2, LI Wugen2, XIA Guojin2
(1.Department of CT Room, Dafeng Hospital of Chaoyang District in Shantou City, Shantou 515154, China; 2.Imaging Department, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China)
[Abstract] Objective: To analyze the CT and MRI manifestations of intracranial fungal infection in order to improve accuracy of the imaging diagnosis. Methods: 7 cases of intracranial fungal infection were analyzed retrospectively, fungal granuloma or abscess in 5 cases, 1 case of single and multiple in 4 cases, while 3 cases involving the meninges, fungal meningitis in 2 cases. Results: Intracranial fungal meningitis involved widely of basal cistern and the brain convexity meninges, gyrus-like enhancement in the subarachnoid sapce of the sulci and cisterns. The multiple and smaller fungal granuloma or abscess lesions located in deep, CT showed mixed density, the enhanced abscess thick wall showed irregular, non-continuity, which expressed as "open-loop sign"; T1-weighted imaging showed medium or low signals, T2-weight imaging signal intensity changed in a larger range what was characterized by slightly lower performance. Accompanied by local epidural abscess and strengthened arachnoid. Conclusion: Intracranial fungal granuloma has certain imaging performance of CT and MRI such as "open-loop sign" and slightly lower T2 signal. Although the typical mold of fungal meningitis strengthened, but it is difficult to differentiate with tuberculous meningitis.
[Key words] Fungal infection; Granuloma; X-ray computed tomography (CT); Magnetic resonance imaging (MRI) ......
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