摘要
目的:探讨肥厚性硬脑膜炎的影像学特征。方法:搜集近年来文献报道33例肥厚性硬脑膜炎,结合本院1例患者,分析肥厚性硬脑膜炎的临床表现及影像学特征。患者CT平扫5例,平扫加增强7例;MRI平扫2例,直接增强2例,平扫加增强25例。结果:CT平扫主要表现为天幕(50%,6/12)、大脑镰(33%,4/12)等处硬脑膜增厚,密度增高;增强后病灶明显强化。MRI平扫显示增厚硬脑膜位于天幕(62%,18/29)、大脑镰(41%,12/29)、鞍旁海绵窦(31%,9/29)、颅底(28%,8/29)、大脑凸面(48%,14/29)等处硬脑膜。病灶T1WI呈低信号(26%,7/27)、等信号(59%,16/27),T2WI呈低信号(70%,19/27)、等信号(7%,2/27)、高信号(7%,2/27)。增强后病灶显著强化(96%,26/27),轻度强化1例(4%,1/27)。病灶邻近脑实质水肿,MRI呈斑点状长T1长T2信号,其中大脑半球4例(15%,4/27),小脑半球1例(4%,1/27)。中耳炎表现11例(32%,11/34)。结论:HCP具有特征性MRI表现,在排除了其他肉芽肿性疾病及感染性病变后,根据患者的症状及影像学特征即可做出可靠诊断。
Objective ： To investigate the imaging features of the hypertrophic cranial paehymeningitis （HCP）.Methods ： Collected 33 casas .of HCP recently reported in the literature, combined with one case of HCP in our hospital, the clinical manifestations and imaging characteristics of 34 casas of HCP were analyzed.Patients with CT plain scan in 5 cases, plain and enhanced scan in 7 cases ; MRI plain scan in 2 cases, direct enhancement in 2 cases, plain and enhanced in 25 cases.Results ： CT scan mainly showed dural thickening, increased density for the tentorium of cerebellum （50%, 6/12）, falx cerebri （33%, 4/12） and the lesion showed significant enhancement after contrast injection.MRI scan showed thickening of the dura mater in the Tentorium of cerebellum （62%, 18/29）, falx eerebrl （41%, 12129）, parasellar cavernous sinus （31%, 9/29）, base of the skuU（28%, 8/29）, cerebral convex （48%, 14/29）.The dura mater showed low signal on T1WI （26%, 7/27） and signal equal to the cerebral gray matter （59%, 16/27）, low signal on T2WI （70%, 19/27）, signal equal to the cerebral gray matter （7%, 2/27） and high signal （7%, 2/27）.The focus showed significant enhancement after Gd-DTPA injected （96%, 26/27）, slight enhancement in 1 cases （4%, 1/27）.The brain parenchyma with edema adjacent to the lesion MRI showed low signal on T1WI and high signal on T2WI, in which the brain hemisphere in 4 eases （15%, 4/27）, eerebellar hemisphere in 1 cases （4%, 1/27）.Among them, otitis media presentation in 11 cases （32%, 11/34）. Conclusion ： MRI can show the features of HCP, in the exclusion of other granulomatous diseases and infectious diseases, a reliable diagnosis can be made according to the patient＇s symptoms and imaging features.
出处
《中外医学研究》
2012年第31期38-41,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
肥厚性硬脑膜炎
影像学
Hypertrophic cranial pachymeningitis
Imaging
