【摘要】 目的 评估MRI对颅内结核性脑膜炎的诊断价值。 材料与方法 对18例颅内结核性脑膜炎的MRI表现、Gd-DTPA增强的作用和追踪MRI的变化进行分析。 结果 MRI显示脑膜炎13例，表现为蛛网膜腔狭窄和消失，脑脊液分房。在增强MRI上，受累的脑膜呈线形、弥漫性斑块和结节状或环状显著性强化。结核性脑膜炎合并结核瘤2例，结核性脑脓肿2例，脑梗塞1例。 结论 结核性脑膜炎的MRI表现有一定的特点，增强MRI可以清楚地显示出结核性脑膜炎受累的形态学和病理学改变。因此，MRI检查对颅内结核性脑膜炎的诊断价值，无论是在急性期或慢性期，均优于CT检查。

SHEN Hailin, GUO Liang, HU Chunhong,et al. MedicalImaging Center, No.1 Affiliated Hospital, Suzhou Medical College, Suzhou, Jiangsu Province215006, P.R.China

【Abstract】 Objective To evaluate MRI for thediagnosis of intracranial tuberculous meningitis. Materials and Methods Thenon-enhanced and Gd-DTPA enhanced MRI features in 18 patients with intracranialtuberculous meningitis were analyzed. Results Meningitis was found by MRI in 13 cases,presenting on non-enhanced MRI as obliteration of subarachnoid space and loculation ofcerebrospinal fluid. On Gd-DTPA enhanced MRI, linear, diffuse plaque-like and nodularenhancement on the surface of the involved meninges was seen. Tuberculous meningitiscombined with tuberculoma was seen in 2 cases, with tuberculous abscesses in 2 and withcerebral infarction in one. Conclusion Tuberculous meningitis carries some certaincharacteristics on MRI. Gd-DTPA enhanced MRI can well demonstrate the morphological andpathological evidence of involved meninges. Therefore, MR is superior to CT in diagnosingtuberculous meningitis in both acute stage and chronic stage of the disease.

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