广州医药 ›› 2021, Vol. 52 ›› Issue (2): 58-62.DOI: 10.3969/j.issn.1000-8535.2021.02.013

• 论著 • 上一篇    下一篇

MR增强T2FLAIR技术在结核性脑膜炎诊断价值中的研究

俞新华, 李蔚宇, 唐城, 任会丽, 宋敏, 方伟军   

  1. 广州市胸科医院放射科 (广州 510095)
  • 收稿日期:2020-09-14 出版日期:2021-03-20 发布日期:2021-11-25
  • 通讯作者: 方伟军,E-mail:fangweijun71@163.com
  • 基金资助:
    广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]155号)

Study on the diagnostic value of MR enhanced T2FLAIR techniques in tuberculous meningitis

YU Xinhua, LI Weiyu, TANG Cheng, REN Huili, SONG Min, FANG Weijun   

  1. Department of Radiology, Guangzhou Chest Hospital, Guangzhou,510095, China
  • Received:2020-09-14 Online:2021-03-20 Published:2021-11-25

摘要: 目的 探讨增强T2FAIR系列在结核性脑膜炎(TBM)中的诊断价值。方法 选择临床疑似TBM并初次行MR检查的患者80例,根据TBM诊断评分标准和颅内结核影像学分型专家共识作为临床确诊依据。最终56例经临床确诊为TBM(脑脊液结核杆菌抗酸检测阳性)。行常规系列颅脑扫描后增加增强T2FIR系列扫描。由三位经验丰富从事影像专业诊断不同级别的医师分别进行独立分析诊断,以明显强化、轻度强化和无明显强化对比分析增强三维快速扰相梯度回波T1WI(T1GRE3D-FS)序列和增强T2FIR系列对TBM脑膜病变和脑实质的显示程度。结果 增强T2FLAIR系列52例显示脑膜明显强化占92.5%;4例不明显强化占7.5%。T1GRE3D-FS序列 8例明显强化占14%,39例轻度强化占70%;9例无明显强化占16%。增强T2FLAIR系列43例显示脑实质明显强化占76.8%;13例轻度强化占23.2%。T1GRE3D-FS序列48例明显强化占86%;8例轻度强化占14%。两系列对脑实质的显示均有轻度强化。结论 增强T2FAIR系列可作为TBM早期常规系列用于TBM的MR增强检查,能显著提高TBM影像诊断的准确性,,弥补了常规MR增强TlWI对结核性脑膜炎诊断的不足。

关键词: MR增强T2FAIR, 结核性脑膜炎, 诊断价值

Abstract: Objective To investigate the diagnostic value of enhanced T2FAIR series in tuberculous meningitis (TBM) patients. Methods 80 patients with suspected clinical TBM and initial MR examination were selected as the basis for clinical diagnosis according to the TBM diagnostic scoring standard and the expert consensus of intracranial tuberculosis imaging classification. Finally,56 cases were clinically confirmed as positive for acid resistance in TBM. Enhanced T2FIR series scans were added after routine series craniocerebral scanning. Independent diagnostic analysis was performed by three experienced imaging specialists. By different levels of diagnosis with significant enhancement, mild enhancement and no mild enhancement, we made contrast analysis in display of enhanced three-dimensional fast scrambling phase gradient echo T1WI (T1GRE3D-FS) sequence and enhanced T2FIR series on TBM meningeal lesions and brain parenchyma. Results 52 cases of enhanced T2FLAIR series showed significant enhancement of the meninges in 92.5%; in 4 cases,7.5% were not significantly enhanced. 8 cases of T1GRE3D-FS sequences were significantly enhanced, accounting for 14%, 39 cases of mild enhancement accounted for 70%; no significant enhancement was found in 9 cases, accounting for 16%. Enhanced T2FLAIR series of 43 cases showed significant enhancement of brain parenchyma accounted for 76.8%; 13 cases of mild enhancement accounted for 23.2%. 48 cases of T1GRE3D-FS sequences were significantly enhanced accounted for 86%; 8 cases of mild enhancement accounted for 14%. Both series showed mild enhancement of brain parenchyma. Conclusion The enhanced T2FAIR series can be used as TBM early routine series for MR enhanced examination, it may significantly improve the accuracy of TBM imaging diagnosis, to make up the deficiency of conventional MR.

Key words: MR enhanced T2FAIR, Tuberculous meningitis, Diagnostic value