摘要
目的分析核磁共振成像(MRI)在脑内炎性脱髓鞘假瘤的影像学特征,以提高脑内炎性脱髓鞘假瘤的诊断效能。方法总结自2016年6月至2021年6月经开封市中心医院临床诊治的30例脑内炎性脱髓鞘假瘤患者的临床及影像资料。结果30例患者共检出48个病灶,22例孤立性肿瘤样病灶,8例患者共26个多发病灶。MRI平扫48个病灶呈均匀性或者不均匀性长T_(1)、T_(2)信号影,液体衰减反转恢复(FLAIR)序列48个病灶呈不均匀性高信号影,磁共振弥散成像(DWI)序列40个病灶呈不均匀性高信号影,表观扩散系数(ADC)值不同程度减低;8个病灶未见明显高信号影。40个病灶DWI信号随着时间的延长,DWI信号强度逐渐减低,ADC值逐渐增高。MRI增强扫描42个病灶呈不同形态轻度-明显强化,6个病灶未见明显异常强化。16个病灶呈开环状强化,12个病灶呈环状强化,6个病灶呈垂直于侧脑室火焰状强化,8个病变呈不典型多发小斑片状、结节样强化。结论脑内炎性脱髓鞘假瘤具有开环状,环状强化或火焰状强化等典型的影像学特征,较易诊断。而不典型结节样、斑片状强化不易与脑肿瘤鉴别,要结合临床特征及MRI复查。脑内炎性脱髓鞘假瘤DWI病灶随着时间的延长,DWI病灶信号强度逐渐减低,有助于提高临床诊断。
Objective To summarize the imaging features of total tuberculosis magnetic resonance imaging(MRI)in brain inflammatory demyelinating pseudotumors,so as to improve the diagnostic efficiency of inflammatory demyelinating pseudotumor in brain.Methods A total of 30 patients with intracerebral inflamma-tory demyelinating pseudotumor were clinically diagnosed and treated in our hospital from June 2016 to June 2021,and the clinical and imaging data were summarized as the research objects.Results Totally,48 lesions were detected in 30 patients,with 22 solitary tumor-like lesions,and 8 patients had 26 multiple lesions.MRI plain scan for 48 lesions showed uniform or non-uniform long T_(1) and T_(2) signal shadows.The 48 lesions in the fluid-attenuated inversion recovery(FLAIR)sequence displayed heterogeneous high-intensity shadows,40 lesions in diffusion weighted imaging(DWI)sequence had uneven high signal shadow,and apparent diffusion coefficient(ADC)value decreased to various degrees.There was no obvious high signal shadow in 8 lesions.With the exten-sion of time,the DWI signal intensity of 40 lesions gradually decreased,while the ADC value gradually incre-ased.MRI-enhanced scan for 42 lesions showed different shapes,and they were significantly enhanced,and no obvious abnormal enhancement was seen in 6 lesions.Meanwhile,16 lesions displayed open ring enhan-cement,12 lesions of ring enhancement,and 6 lesions of flame enhancement perpendicular to the lateral ventr-icle,and 8 lesions of atypical multiple small patchy and nodular enhancements.Conclusion Infl-ammatory demyelinating pseudotumors in brain have certain imaging features,such as open ring,ring enhan-cement or flame enhance-ment,and other typical imaging features,so the diagnosis is not difficult.A typical nodular and patchy enhan-cements are not easy to be distinguished from brain tumors,and should be combined with clinical features and MRI review.The DWI lesions of inflammatory demyelinating pseudotumors in brain gradually reduce the signal intensity of the DWI l
作者
李冠军
钱伟军
Li Guanjun;Qian Weijun(Department of Medical Imaging,Kaifeng Central Hospital,Henan 475000,China)
出处
《实用医技杂志》
2022年第5期491-494,共4页
Journal of Practical Medical Techniques
关键词
磁共振成像
脱髓鞘疾病
肉芽肿
浆细胞
Magnetic resonance imaging
Demyehination diseases
Granuloma,plasma cell
