發(fā)布時間：2018-01-27 15:53

  本文關(guān)鍵詞： 結(jié)核性腦膜炎 臨床分期 磁共振掃描 改良抗酸染色　出處：《中風(fēng)與神經(jīng)疾病雜志》2017年02期 　論文類型：期刊論文

【摘要】：目的探討結(jié)核性腦膜炎(TBM)患者頭部CT及MR檢查特點及在各病程分期中的診斷價值,為臨床診治提供參考。方法選取2013年2月-2016年6月我院收治的125例結(jié)核性腦膜炎患者為研究對象,所選患者均為腦脊液改良抗酸染色陽性的確診患者�；颊咧心行�78例,女性47例,患者年齡在14~76歲之間,中位數(shù)年齡為37歲,所有患者均進(jìn)行頭部CT及MRI影像學(xué)檢查,其中28例同時行增強MRI掃描,分析其臨床分期與影像學(xué)表現(xiàn)。結(jié)果 125例結(jié)腦患者中,Ⅰ期患者31例,Ⅱ期55例,Ⅲ期39例。影像學(xué)結(jié)果顯示,最常見的表現(xiàn)依次是腦膜強化、腦積水、結(jié)核瘤等。隨著患者臨床分期的增加,CT及MRI對顱內(nèi)病灶的敏感度提高。Ⅰ期患者主要表現(xiàn)為腦膜強化、基底池滲出;Ⅱ和Ⅲ期患者影像學(xué)表現(xiàn)多樣,為腦積水、腦梗死、結(jié)核瘤、炎性病灶等表現(xiàn)。CT發(fā)現(xiàn)異常者41例,敏感度為33%,其中Ⅰ期為13%,Ⅱ期為33%,Ⅲ期為49%。MRI發(fā)現(xiàn)異常者為90例,敏感度為72%,其中Ⅰ期為48%,Ⅱ期為78%,Ⅲ期為82%。增強MRI發(fā)現(xiàn)異常為23例,敏感度為82%,并可發(fā)現(xiàn)頭部CT和MRI平掃陰性的病變。結(jié)論頭部影像學(xué)特別是MRI能清楚顯示結(jié)核性腦膜炎的各種病理改變,敏感度隨著臨床分期的增加而增加。早期檢查陽性率低、表現(xiàn)單一;中晚期檢查陽性率高、表現(xiàn)多樣。結(jié)合增強MRI可提高結(jié)核性腦膜炎檢出率并為臨床診斷結(jié)核性腦膜炎提供可靠依據(jù)。
[Abstract]:Objective to investigate the CT and Mr features of head in patients with tuberculous meningitis (TBM) and its diagnostic value in different stages of the disease course. Methods 125 cases of tuberculous meningitis treated in our hospital from February 2013 to June 2016 were selected as the research object. All the patients were diagnosed with positive CSF modified acid-fast staining. 78 cases were male and 47 cases were female. The age of the patients was between 14 and 76 years old, the median age was 37 years old. All the patients were examined by CT and MRI, 28 of them were examined by enhanced MRI, and their clinical staging and imaging findings were analyzed. The imaging findings showed that the most common manifestations were meningeal enhancement hydrocephalus tuberculoma and so on. The sensitivity of CT and MRI to intracranial lesions was increased. In stage I patients, meningeal enhancement and basal cistern exudation were the main manifestations. The imaging manifestations of patients with stage 鈪，

本文編號：1468832