中枢神经系统结节病：未增强与增强磁共振图像的比较
Sarcoidosis of the CNS: comparison of unenhanced and enhanced MR images.
作者信息
Sherman J L, Stern B J
机构信息
Washington Imaging Center, Kensington, MD 20895.
出版信息
AJNR Am J Neuroradiol. 1990 Sep-Oct;11(5):915-23.
Sarcoidosis involving the CNS has a predilection for the leptomeninges, although parenchymal involvement occurs. We retrospectively evaluated the appearance of CNS sarcoidosis on unenhanced and enhanced MR images. MR studies were abnormal in 17 of 20 patients with CNS sarcoidosis. In all 17 patients, meningeal disease was detected on the gadopentetate-dimeglumine-enhanced T1-weighted images; the disease was detected on unenhanced images in three patients. Well-defined leptomeningeal patterns of enhancement were present in 15 patients. Other areas of involvement were the dura; brain parenchyma including hypothalamus, periventricular white matter, and ventricular ependyma; optic chiasm; and pituitary gland. Gadopentetate dimeglumine optimally evaluates meningeal disease and highlights the importance of the leptomeninges and Virchow-Robin spaces in the pathogenesis of CNS sarcoidosis. Enhanced MR is the preferred imaging technique for the evaluation of CNS sarcoidosis.
结节病累及中枢神经系统时，虽可出现实质受累，但更易侵犯软脑膜。我们回顾性评估了中枢神经系统结节病在平扫及增强磁共振成像（MR）上的表现。20例中枢神经系统结节病患者中，17例的MR检查结果异常。在所有17例患者中，钆喷酸葡胺增强T1加权像上均检测到脑膜病变；3例患者在平扫像上检测到病变。15例患者出现边界清晰的软脑膜强化模式。其他受累部位包括硬脑膜；脑实质，包括下丘脑、脑室周围白质和脑室室管膜；视交叉；以及垂体。钆喷酸葡胺能最佳地评估脑膜病变，并突显了软脑膜和血管周围间隙在中枢神经系统结节病发病机制中的重要性。增强MR是评估中枢神经系统结节病的首选影像学技术。
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