脑及脑膜的强化类型.docx

From the Archives of the AFIP美国陆海空三军病理研究所的文献Patterns of Contrast Enhancement in the Brain and Meninges脑及脑膜的强化类型 RadioGraphics 2007; 27:525–551 第一部分 LEARNING OBJECTIVES FOR TEST 6学习目标 （PS：很遗憾，Test 6需要15美元方可获得测试题目，手头拮据而无法获得，真乃一大憾事！但我把测试题目的网址公布出来，希望有办法的高手们能够把测试题目全部搞定：/Timssnet/products/TNT_products.cfm?prod=2726）After reading this article and taking the test, the reader will be able to:学习本文并通过测验后，您应该可以：●Define contrast enhancement as it applies to CT and MR imaging of the brain and meninges.●对CT及MRI所示的脑部及脑膜的强化影像进行解释。●Explain the role of the blood-brain barrier and vascularity in contrast enhancement in the central nervous system.●解释血脑屏障及新血管生成在中枢神经系统强化影像机制中的作用。●Use the patterns of enhancement to distinguish different pathologic processes in the brain and meninges.●利用您所掌握的中枢神经系统强化病灶的类型特点，对脑部及脑膜的病变进行鉴别诊断。 Abstract摘要 Contrast material enhancement for cross-sectional imaging has been used since the mid 1970s for computed tomography and the mid 1980s for magnetic resonance imaging. Knowledge of the patterns and mechanisms of contrast enhancement facilitate radiologic differential diagnosis. Brain and spinal cord enhancement is related to both intravascular and extravascular contrast material. Extraaxial enhancing lesions include primary neoplasms (meningioma), granulomatous disease (sarcoid), and metastases (which often manifest as mass lesions). Linear pachymeningeal (dura-arachnoid) enhancement occurs after surgery and with spontaneous intracranial hypotension. Leptomeningeal (pia-arachnoid) enhancement is present in meningitis and meningoencephalitis. Superficial gyral enhancement is seen after reperfusion in cerebral ischemia, during the healing phase of cerebral infarction, and with encephalitis. Nodular subcortical lesions are typical for hematogenous dissemination and may be neoplastic (metastases) or infectious (septic emboli). Deeper lesions may form rings or affect the ventricular margins. Ring enhancement that is smooth and thin is typical of an org