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目的探讨不同分型脑囊尾蚴病的影像学特征。方法对166例经临床确诊的脑囊尾蚴病患者的CT及MRI表现进行回顾性分析。结果 166例脑囊尾蚴病患者中,脑实质型108例,脑室型15例,脑膜型3例,混合型40例。各型脑囊尾蚴病CT、MRI特点:1脑实质型脑囊尾蚴病可分为急性期型(囊泡型、脑炎型、多发环形或结节状强化型)和慢性钙化型。囊泡型:CT表现为单发或多发囊状影,边界清楚,囊内可见高密度头节;MRI表现为类圆形长T1、长T2信号,囊内可见偏心附壁的点状影,囊壁及头节为等信号,增强后无明显强化;脑炎型:CT呈散在低密度灶,MRI表现为斑片状稍长T1、长T2信号,多数无明显强化或不规则强化;结节状或多发环形强化型:CT平扫为多发结节状低密度灶,增强扫描呈多发结节或环形强化;慢性钙化型:CT表现为单发或多发的圆点状高密度影,MRI上表现为等或长T1、短T2信号。2脑室型:常发生于第三、四脑室,可并发阻塞性脑积水。3脑膜型:脑脊液间隙局限性扩大且不对称,可出现交通性脑积水,增强扫描后可出现软脑膜强化。4混合型:表现为上述2种或以上类型并存,急、慢性期影像混合存在。结论不同分型脑囊尾蚴病影像学表现各不相同,分析这些独特的影像学特征对脑囊尾蚴病患者的临床诊治及预后评判具有重要意义。
Objective To investigate the imaging features of different types of cerebral cysticercosis. Methods The CT and MRI findings of 166 patients with clinically diagnosed cerebral cysticercosis were analyzed retrospectively. Results 166 cases of cerebral cysticercosis patients, the brain parenchyma 108 cases, 15 cases of ventricular, meningeal 3 cases, mixed 40 cases. Various types of cerebral cysticercosis CT, MRI features: 1 brain parenchymal cysticercosis can be divided into acute stage (vesicular, encephalitis, multiple ring or nodular enhancement) and chronic calcification. Vesicular type: CT showed single or multiple cystic shadow, the border is clear, high-density cadaver can be seen within the first section; MRI showed round long T1, T2 signal, the capsule can be seen in the annexation of the eccentric point of the shadow, Encephalitis type: CT was scattered in low-density lesions, MRI showed patchy long T1, T2 signal, the majority of no significant enhancement or irregular enhancement; node Nodular or multiple annular enhancement type: CT scan for multiple nodular low-density lesions, enhanced scan showed multiple nodules or annular enhancement; chronic calcification: CT showed single or multiple dot-like high density, MRI On the performance of equal or long T1, short T2 signal. 2 ventricular type: often occurs in the third and fourth ventricle, can be complicated by obstructive hydrocephalus. 3 Meningeal type: the limitations of cerebrospinal fluid space expansion and asymmetry, there may be traffic hydrocephalus, increased scan can appear pia mater enhancement. 4 mixed type: the performance of two or more types of coexistence, acute and chronic phase images exist. Conclusion The imaging findings of different types of cerebral cysticercosis are different. It is of great significance to analyze these unique imaging features in clinical diagnosis and prognosis of patients with cerebral cysticercosis.