多模态磁共振技术在脑内环形强化病变中的诊断价值
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作者单位:

中南大学湘雅三医院神经内科,湖南 长沙 410013

作者简介:

曾旖旎(1999—),女,硕士研究生,主要从事癫痫临床研究。Email: zyn20200212@163.com。

通信作者:

郑文(1976—),男,神经内科副主任,副主任医师,硕士研究生导师,主要从事癫痫临床与基础研究。Email: zhengwen5309@163.com。

基金项目:

湖南省自然科学基金(2020JJ4865、S2021JJMSXM2689),湖南省临床医学技术创新指导项目(2020SK53612)。


Value of multimodal magnetic resonance imaging in diagnosis of ring-enhancing lesions in the brain
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Affiliation:

Department of Neurology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China

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    摘要:

    目的 总结脑内环形强化病变的神经影像学特点,探讨多模态磁共振技术在脑内环形强化病变中的诊断价值。方法 回顾分析2015年1月—2023年1月中南大学湘雅三医院就诊的67例脑内环形强化病变患者多模态磁共振特点、影像学诊断、临床确诊报告及预后等相关临床资料。结果 67例脑内环形强化病变患者中,胶质瘤26例,转移瘤20例,脑脓肿7例,脱髓鞘病变5例,淋巴瘤3例,其他病变6例。常规MRI序列(T1WI、T2WI、FIAIR和增强)尽管能清晰显示脑内环形强化灶的部位、形态、灶周水肿程度等特点,但定性诊断困难。结合其他多模态磁共振序列(MRS、DWI、PWI等)的影像学特点,并构建影像学鉴别诊断流程图,57例患者得出了较明确的影像学诊断,其中54例患者的影像学诊断与最终临床诊断相符。结论 多模态磁共振技术(MRS、DWI、PWI等)通过解析脑内环形强化病变的病理生理特点,结合程序性鉴别诊断分析,显著提高了影像学诊断的准确率。

    Abstract:

    Objective To investigate the neuroimaging characteristics of intracranial ring-enhancing lesions and the value of multimodal magnetic resonance imaging (MRI) in the diagnosis of such lesions.Methods A retrospective analysis was performed for the clinical data of 67 patients with intracranial ring-enhancing lesions who were treated in Third Xiangya Hospital, Central South University, from January 2015 to January 2023 and underwent multimodal MRI, including imaging characteristics, imaging diagnosis, report of clinical confirmed diagnosis, and prognosis.Results Among the 67 patients with intracranial ring-enhancing lesions, there were 26 patients with glioma, 20 patients with metastatic tumors, 7 patients with encephalopyosis, 5 patients with demyelinating lesions, 3 patients with lymphomas, and 6 patients with other diseases. Although conventional MRI sequences (T1WI, T2WI, FIAIR, and contrast-enhanced examination) can clearly display the location and shape of ring-enhancing lesions and the degree of perifocal edema, it is difficult to make a qualitative diagnosis. With reference to the imaging characteristics of other multimodal magnetic resonance sequences (such as MRS, DWI, and PWI) and the construction of a flow chart for imaging differential diagnosis, a relatively clear imaging diagnosis was made for 57 patients, among whom 54 patients had an imaging diagnosis consistent with the final clinical diagnosis.Conclusion Multimodal magnetic resonance techniques (including MRS, DWI, and PWI) significantly improve the accuracy of imaging diagnosis by analyzing the pathophysiological characteristics of intracranial ring-enhancing lesions in combination with the programmed differential diagnostic analysis.

    图1 脑内环形强化病变Fig.1
    Fig.
    Fig.
    图3 脱髓鞘假瘤的多模态MR图像Fig.3
    图4 原发性中枢神经系统淋巴瘤的多模态MR图像Fig.4
    表 4 磁共振技术在脑内环形强化病变中的应用及诊断价值Table 4
    表 3 脑内环形强化病变的多模态磁共振影像特点Table 3
    表 2 脑内环形强化病变的病因Table 2
    表 1 Table 1
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曾旖旎,李文君,朱安定,陈茹,宋治,郑文456.多模态磁共振技术在脑内环形强化病变中的诊断价值[J].国际神经病学神经外科学杂志,2024,51(1):7-16111ZENG Yini, LI Wenjun, ZHU Anding, CHEN Ru, SONG Zhi, ZHENG Wen222. Value of multimodal magnetic resonance imaging in diagnosis of ring-enhancing lesions in the brain[J]. Journal of International Neurology and Neurosurgery,2024,51(1):7-16

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  • 收稿日期:2023-05-11
  • 最后修改日期:2024-01-05
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  • 在线发布日期: 2024-04-09
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