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脑裂头蚴病的CT及MRI表现

         

摘要

Purpose To explore the CT and MR manifestations of cerebral sparganosis. Materials and Methods Fifteen patients with cerebral sparganosis confirmed by clinical laboratory test or pathology were respectively analyzed. Imaging data included 12 cases of plain CT scan, 10 cases of enhanced CT scan, 15 cases of pre-and post-contrast MRI scan. Results 13 cases were solitary, and 11 of them showed low-density lesions in the brain parenchyma on pre-contrast CT with ill-defined margin and isodense or high-density nodule or strips; sand-like calcification was reviewed in 9 of them. On post-contrast images, these lesions showed nodular or striped enhancement. On thin section,"hollow nodule sign" was found. On MRI, 13 cases showed iso- or low-intensity on T1WI and heterogenous high-intensity on T2WI. After contrast, the lesions showed rosary, distort roped-like or irregular nodular enhancement with low-signal intensity in the lesion as"tunnel sign". 2 cases were multiple lesions, 1 of them displayed diffused multiple nodular and irregular ring enhancement on both enhanced CT and MR images. The other cases of proliferative brain sparganosis showed multiple miliary enhancement on post-contrast MRI scan. The location and morphology changes were found in 4 cases of follow-up CT scan and 8 cases of follow-up MRI scan. Conclusion MRI manifestations of rosary, distort rope-like enhancement are imaging characteristics of brain sparganosis. CT is superior on showing small calcification."Hollow nodule sign"and"tunnel sign"are most valuable for the diagnosis. Transmigration is another characteristic of the disease. Diagnosis can be confirmed when combined with possible infection history and immunological tests.%  目的探讨脑裂头蚴病的CT及MRI表现。资料与方法回顾性分析15例经临床、实验室检查或手术病理证实的脑裂头蚴病患者的CT及MRI资料,其中12例行CT平扫,10例行CT增强扫描,15例行MRI平扫及增强扫描。结果13例病灶单发,其中11例CT平扫示脑实质内边界不清的低密度区伴等或稍高密度结节或条带影,9例见小砂粒状钙化灶,增强后病灶呈结节状、条索样强化,薄层图像显示病灶呈“空心结节征”。13例MRI T1WI病灶呈等或稍低信号,T2WI呈不均匀高信号,增强后呈串珠状、扭曲绳索样及不规则结节样强化,病灶内均可见低信号“隧道征”。2例病灶多发,其中1例CT及MRI增强示多个结节及不规则环形强化灶散在分布,未见典型“隧道征”,1例“增殖型”脑裂头蚴病MRI增强扫描呈多发粟粒样强化。4例CT复查、8例MRI复查均发现病灶位置及形态发生改变。结论MRI显示串珠样或扭曲绳索样强化是脑裂头蚴病的影像特征,CT显示小钙化灶优越。“隧道征”、“空心结节征”对诊断最有价值,病灶游走是本病的另一特点,结合可能的感染史和免疫学检查可明确诊断。

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