Lu Tingting, Zou Yan, Jiang Ting, Yang Yu, Wu Aimin, Chen Hongbing, Kang Zhuang, Lin Xinqing, Fang Yimin, Lu Zhengqi
Department of Neurology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Clin Neuroradiol. 2020 Jun;30(2):381-388. doi: 10.1007/s00062-019-00766-4. Epub 2019 May 3.
The features of intracranial arterial injury in tuberculous meningitis (TBM) are of important diagnostic and prognostic value. The study aimed to elucidate the high-resolution vessel wall imaging (HR-VWI) manifestations of intracranial arterial insults in TBM.
The clinical data, routine cranial magnetic resonance imaging, magnetic resonance angiography (MRA) and HR-VWI before and after contrast enhancement of intracranial arteries in clinically diagnosed TBM patients were retrospectively analyzed.
In this study 27 TBM patients were included. Abnormalities in the intracranial arteries were detected in all patients using HR-VWI. Typical vessel insults included nodular or granular lesions, related thickness and prominent enhancement in the wall, and lumen narrowing or occlusion. The most frequently involved arteries were the C4 segment of the internal carotid artery and the P1 segment of the posterior cerebral artery. The lesions were consistent with disease stage and disease duration and correlated with infarction.
The use of HR-VWI revealed that cerebral artery involvement in patients with TBM is much more common and extensive than in previous radiological reports. The use of HR-VWI improves recognition of arterial pathologies and has diagnostic value in patients with TBM.
结核性脑膜炎（TBM）颅内动脉损伤的特征具有重要的诊断和预后价值。本研究旨在阐明TBM颅内动脉损伤的高分辨率血管壁成像（HR-VWI）表现。
回顾性分析临床诊断为TBM患者的临床资料、常规头颅磁共振成像、磁共振血管造影（MRA）以及颅内动脉对比增强前后的HR-VWI。
本研究纳入27例TBM患者。所有患者通过HR-VWI均检测到颅内动脉异常。典型的血管损伤包括结节状或颗粒状病变、相关的血管壁厚度及强化增强，以及管腔狭窄或闭塞。最常受累的动脉是颈内动脉C4段和大脑后动脉P1段。这些病变与疾病分期和病程一致，并与梗死相关。
HR-VWI的应用显示，TBM患者脑动脉受累比以往放射学报告更为常见和广泛。HR-VWI的应用提高了对动脉病变的认识，对TBM患者具有诊断价值。
