Offenbacher H, Fazekas F, Schmidt R, Kleinert R, Payer F, Kleinert G, Lechner H
Universitätsklinik für Neurologie, Karl-Franzens Universität, Graz, Austria.
J Neurol. 1991 Sep;238(6):340-4. doi: 10.1007/BF00315335.
The contribution of MRI is reported in four adult patients with tuberculous meningoencephalitis (TbM) and with autopsy correlation in one. Contrast-enhanced T1-weighted MRI revealed the characteristic basal meningeal inflammation of TbM and its focal spreading into adjacent brain. Mixed and T2-weighted pulse sequences delineated a plethora of parenchymal abnormalities. Their relation to TbM was established by a close matching of the patient's neurological findings, contrast enhancement or a change in lesion size. The latter accurately reflected the clinical course in all patients. It remained difficult, however, to distinguish between ischaemic and inflammatory changes, which in some locations were intermixed even histologically. From our experience and that of other groups, MRI provides more diagnostic information in TbM than CT. Moreover, MRI promises to be a useful tool for monitoring treatment response.
本文报告了4例成年结核性脑膜脑炎（TbM）患者的MRI表现，其中1例有尸检结果对照。对比增强T1加权MRI显示了TbM典型的基底脑膜炎症及其向邻近脑实质的局灶性扩散。混合序列和T2加权脉冲序列勾勒出大量脑实质异常。通过将患者的神经学表现、对比增强或病变大小的变化进行紧密匹配，确定了它们与TbM的关系。后者在所有患者中均准确反映了临床病程。然而，区分缺血性和炎症性改变仍然困难，在某些部位，即使在组织学上两者也相互混杂。根据我们和其他研究组的经验，MRI在TbM中比CT能提供更多的诊断信息。此外，MRI有望成为监测治疗反应的有用工具。
