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[需要与肿瘤相鉴别的小脑梗死:MRI诊断]

[Cerebellar infarcts that require differentiation from tumors: diagnosis with MRI].

作者信息

Yamaki T, Tanabe S, Takamura Y, Yamamura A, Ochi S, Nakagawa T, Hashi K

机构信息

Shin Sapporo Neurosurgical Hospital.

出版信息

No Shinkei Geka. 1994 Apr;22(4):349-52.

PMID:8164800
Abstract

It is often difficult to differentiate cerebellar infarct with cerebellar swelling from neoplastic disorders, because former can be shown as cerebellar mass with marked contrast enhancement on CT scan. We analyzed radiologically three cases with cerebellar infarction by using MRI, conventional CT scan and angiography. Two cases in the acute stage could be diagnosed as cerebellar infarction by MRI alone based on the following findings: 1) the lesion was distributed in the territory of cerebellar arteries; 2) the normal pattern of cerebellar folia and fissures was preserved in Gd enhancement MRI image; 3) characteristics of MRI intensity were compatible with hemorrhagic infarction. The other case in the chronic stage showed peculiar enhancement, which was unusual for infarction. It was diagnosed as cellular infarction with reference to the angiographic findings. MRI is generally useful to obtain early diagnosis of tumor-like cerebellar infarcts, and proper treatment should be started as early as possible.

摘要

小脑梗死伴小脑肿胀与肿瘤性疾病的鉴别通常很困难,因为前者在CT扫描上可表现为有明显对比增强的小脑肿块。我们通过MRI、传统CT扫描和血管造影对3例小脑梗死病例进行了影像学分析。急性期的2例病例仅凭MRI即可诊断为小脑梗死,基于以下表现:1)病变分布在小脑动脉供血区域;2)钆增强MRI图像中保留了正常的小脑叶和裂的形态;3)MRI信号特征与出血性梗死相符。慢性期的另一例病例表现出特殊的强化,这在梗死中并不常见。结合血管造影结果诊断为细胞性梗死。MRI通常有助于早期诊断肿瘤样小脑梗死,应尽早开始适当治疗。

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