目的：探讨肺吸虫脑病的MRI表现特征及其诊断价值。方法：搜集肺吸虫抗原皮内试验阳性病例6例，均行常规FSE序列MRI平扫、DWI扫描、Gd-DTPA增强扫描。回顾性分析MRI影像表现特征及其与肺吸虫脑病发病机制的关系。结果：6例患者发病年龄为9～20岁，所有扫描病例共计20个病灶，19个病灶位于大脑半球，1个位于基底节区。MRI表现为片絮状和囊状长T1长T2信号，囊状病变的囊壁呈短T1短T2出血信号，6例均示特征性的“隧道征”。增强扫描见环形强化5例，1例不均匀强化。结论：肺吸虫脑病的临床表现具有多变性和多样性，但其多发生于儿童及青少年，MRI表现相对较为典型，“隧道征”及不规则出血信号具有特征性，MRI诊断该病具有重要价值。
Abstract
Objective: To study the MRI features of cerebral paragonimiasis and to assess the value of MRI in the diagnosis of this disease. Methods: Six cases with a positive antibody test of cerebral paragonimiasis were included in the study. Conventional MRI was performed with spin echo pulse sequence, DWI and Gd-DTPA enhancement for all the cases. MRI features and the pathogenesis of cerebral paragonimiasis were retrospectively analyzed. Results: The age of the 6 cases were between 9 and 20 years old. There were 20 lesions in the 6 cases totally, with 19 lesions in the cerebrum and 1 in the basal ganglia region. MRI revealed conglomerated round cysts and edematous area. The cysts had rim of high signal on T1WI, caused by hemorrhage. There were characteristic “tunnel sign” in all the 6 cases. In the Gd-DTPA enhanced images, 5 cases showed patchy or nodular enhancement, and 1 case showed meningeal enhancement. Conclusion: The clinical features of cerebral paragonimiasis are various and diverse, and it often developes in children and adolescents. MRI features of cerebral paragonimiasis are relatively typical. The signal due to hemorrhage and “tunnel sign” are characteristic. MRI is of important value in the diagnosis of the disease.
关键词
吸虫感染 /
肺疾病 /
脑疾病 /
磁共振成像
Key words
Trematode infections /
Lung diseases /
Brain diseases /
Magnetic resonance imaging
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