目的 :分析 31例颅内结核瘤的影像学资料 ,探讨其诊断和鉴别诊断。方法 :回顾性分析 31例经手术病理 (17/31)和抗痨治疗随访 (14 /31)证实为颅内结核瘤的影像学表现。结果 :平片示边缘光滑 ,密度不均的“蛋壳样”钙化。CT示单发或多发 ,等或混杂密度小结节影 ,多发病灶较小 ,病灶 0 .5～ 5 .5cm ;单发病灶偏大 ,(19/31) >2cm ,周围水肿不明显。增强后呈结节状或环状强化。MRI显示T1WI为低或等信号 ,T2 WI为低、等或高信号 ,(11/16 )增强呈结节状强化 ,其余无强化。结论 :典型的颅内结核瘤有特征性影像学表现 ,非典型病灶需与脑脓肿、脑囊虫、胶质瘤和转移瘤鉴别 ,必要时采用穿刺活检或手术病理确诊。强化抗痨治疗后复查CT、MRI可帮助鉴别 ,严格掌握手术适应证 ,可使病人免于手术治疗 Objective: To analyze the imaging data of 31 cases of intracranial tuberculoma and to discuss its diagnosis and differential diagnosis. Methods: The imaging findings of 31 cases of intracranial tuberculoma confirmed by surgical pathology (17/31) and anti-tuberculosis treatment follow-up (14/31) were retrospectively analyzed. Results: Plain radiographs showed “egg shell-like” calcification with smooth edges and uneven density. CT showed single or multiple, etc. or mixed density of small nodules, multiple lesser lesions, lesions 0 .5 ~ 5 .5 cm; single lesions were large, (19/31)> 2cm, the surrounding edema is not obvious. Enhanced nodular or annular enhancement. MRI showed T1WI low or equal signal, T2 WI low, equal or high signal, (11/16) enhanced nodular enhancement, the rest without strengthening. CONCLUSIONS: The typical intracranial tuberculoma has characteristic imaging findings. Atypical lesions need to be distinguished from brain abscess, cerebral cysticercosis, glioma and metastases, and puncture biopsy or surgical pathology if necessary. Intensive anti-tuberculosis treatment after review of CT, MRI can help identify, strictly control the surgical indications, patients can be saved from surgery