摘要
目的回顾性分析脑结核瘤与脑神经胶质瘤的临床资料,以指导临床早期诊断及治疗。方法选择我院6年中收集并经病理和MRI证实脑结核瘤患者(脑结核瘤组)11例和脑神经胶质瘤患者(脑神经胶质瘤组)12例的临床资料,比较两组的症状、既往史、实验室检查、脑MRI表现。结果脑结核瘤组发热和脑膜刺激征者多于脑神经胶质瘤组,分别为81.8%(9/11)vs 0和81.8%(9/11)vs 16.7%(2/12)(均P<0.01);脑结核瘤组结核抗体阳性率、PPD试验阳性率、脑脊液结果异常和血沉升高者多于脑神经胶质瘤组,分别为81.8%(9/11)vs 16.7%(2/12)、72.7%(8/11)vs 25.0%(3/12)、72.2%(8/11)vs 8.3%(1/12)和90.9%(10/11)vs 41.7%(5/12)(P<0.05或<0.01)。两组病理检查结果显著不同,脑结核瘤表现为结核性肉芽肿,脑神经胶质瘤显示肿瘤呈分化不一的幼稚胶质细胞。MRI检查注射对比剂后脑结核瘤呈结节状强化或环状强化,成熟结核结节在T2WI呈典型的"靶征",增强后呈结节状;脑神经胶质瘤MRI加权像上呈低信号,T2WI上呈高信号,大小不一,信号不均,占位效应明显,增强扫描有不同形式的明显强化。结论脑结核瘤与脑神经胶质瘤均为临床罕见疾病,确诊需靠病理检查结果,通过临床症状及体征、脑脊液检查、MRI可以有效区分两种疾病。
Objective To retrospectively analyze and compare the neuropathologic findings of brain tuberculoma and glioma.Methods The study involved 11 patients with brain tuberculoma and 12 patients with glioma who got treatment in the hospital.Comparisons were made between two groups in the clinical data such as clinical manifestations,disease history,laboratory or pathological examination,and magnetic resonance imaging（MRI）.Results Fever,meningeal stimulation sign of brain tuberculoma raised more significantly compared with those of glioma,respectively 81.8%（9/11） vs 0 and 81.8%（9/11）vs 16.7%（2/12）（both P0.01）;tuberculosis antibody positive,PPD test positive,cerebrospinal fluid abnormality,higher erythrocyte sedimentation rate（ESR） of brain tuberculoma increased significantly as compared with those of glioma,respectively,81.8%（9/11） vs 16.7%（2/12）,72.7%（8/11） vs 25.0%（3/12）,72.2%（8/11） vs 8.3%（1/12） and 90.9%（10/11） vs 41.7%（5/12）（P0.05 or 0.01）.The pathological results of two groups were significantly different,pathological findings of brain tuberculoma showed tuberculous granuloma,glioma tumors displayed different differentiated naive glial cells.MRI of both diseases were cricoid aggrandizement,but the MRI of brain tuberculoma after injecting contrast agents showed nodules enhancement or circular aggrandizement,in mature tuberculosis nodules T2WI typical ＂target sign＂.Conclusion Brain tuberculoma and glioma are both rare diseases,the diagnoses rely on clinical findings,CSF,MRI which can increase the diagnostic accuracy.
出处
《临床荟萃》
CAS
2013年第8期841-843,847,F0002,共5页
Clinical Focus
基金
辽宁省社发项目(2012020120-230)
关键词
结核瘤
颅内
神经胶质瘤
磁共振成像
tuberculoma
intracranial
glioma
magnetic resonance imaging
