Brismar J, Hugosson C, Larsson S G, Lundstedt C, Nyman R
Radiology Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Acta Radiol. 1996 Jul;37(4):496-505. doi: 10.1177/02841851960373P214.
To show that intracranial tuberculosis (TB) often masquerades as brain tumour.
Forty-six patients with intracranial TB, who after CT at the local hospital were referred for surgery or radiotherapy of brain tumour, are presented. Sometimes the correct diagnosis was first established during surgery for brain tumour.
The differentiation between TB and gliomas, meningiomas, metastases, or lymphomas may be impossible from the clinical history and CT findings. Angiography, done in 25 of our cases, often helped by not showing the expected tumour vasculature. MR, performed in 9 patients, helped by demonstrating a layered capsule on T2-weighted images in 4 of the lesions (hypointense rim outside hyperintense rim); the centres of the lesions were of decreased, usually very mixed T2 signal intensity.
Even in patients with findings typical of brain tumour, TB remains an important differential diagnosis.
表明颅内结核常伪装成脑肿瘤。
介绍了46例颅内结核患者，这些患者在当地医院进行CT检查后被转诊接受脑肿瘤手术或放疗。有时在脑肿瘤手术期间才首次确立正确诊断。
根据临床病史和CT表现，可能无法区分结核与胶质瘤、脑膜瘤、转移瘤或淋巴瘤。我们的25例患者进行了血管造影，其通常有助于显示未预期的肿瘤血管。9例患者进行了磁共振成像（MR）检查，4个病灶在T2加权图像上显示分层包膜（高信号边缘外的低信号边缘），这有助于诊断；病灶中心T2信号强度降低，通常非常混杂。
即使在具有典型脑肿瘤表现的患者中，结核仍是重要的鉴别诊断。
