医学影像诊断学06脑血管病及颅内感染.ppt

INTRACRANIAL INFECTION Bacterial meningitis is common and is associated with serious morbidity. 细菌性脑膜炎是常见的，有较高的死亡率。 Inflammatory exudates may obscure the subarachnoid cisterns on noncontrasted CT, whereas meningeal enhancement may be observed on CT or MRI following intravenous contrast material administration. (meninges thickening)在非对比的CT上炎性渗出物可以使蛛网膜下腔模糊，而给予静脉造影剂后脑膜增强就可以在CT或MRI上观察到（脑膜变厚） Lack of visible contrast enhancement does not exclude meningitis.缺少可见的对比增强不能排除脑膜炎。 INTRACRANIAL INFECTION Imaging is important for evaluating complications of meningitis.影像学评估脑膜炎的并发症是重要的 Communicating hydrocephalus交通性脑积水 Vasculitis or vasospasm血管炎或血管痉挛 Ischemia or infarction缺血或梗死 Subdural fluid collection硬膜下积液 Spread of infection (e.g. ventriculitis)感染扩散（脑室炎） ABSCESS 脑脓肿 Abscess of the brain usually begins as cerebritis. Cerebritis is initially detected as an area of low attenuation edema on CT or of high signal intensity on T2WI and low signal intensity on T1WI MRI. With time cerebritis progresses to abscess. 脑脓肿通常起始于脑炎。脑炎被最早发现是在CT上是低密度的水肿区或在MRI上T2高信号影，T1低信号影。随时间推移，脑炎可发展为脑脓肿。 ABSCESS Abscess wall is usually fairly thin and uniform, high density on CT, low signal intensity on MRI脓肿壁在CT上通常较薄，厚薄不甚不一致，呈高密度，在MRI上则呈低信号。 Surrounding edema周围水肿 Central fluid attenuation or signal intensity 中心液化区呈水样信号强度 Well-defined ring-like pattern of enhancement 边界清楚的环状强化 ABSCESS Abscess wall is usually fairly thin and uniform, high density on CT. ABSCESS Abscess wall is usually fairly thin and uniform low signal intensity on MRI The differential diagnosis between cerebral abscess and cystic tumor脑脓肿和囊性瘤的鉴别诊断 Multiform glioblastoma多形恶性胶质细胞瘤 Abscess脓肿 Bulk phase容积相 Hydration layer水 TUBERCULOUS MENINGITIS结核性脑膜炎 TUBERCULOUS MENINGITIS结核性脑膜炎 meninges thickening 脑膜增厚并强化 Cranial Trauma Skull颅骨 Penetrating injury穿透性损伤 Closed head injury闭合性头部损伤 Hemorrhage出血 Mass effect占位效应 Shift of intracranial structure颅内结构的移位 Secondary effects: 继发效应 infarction, hydrocephalus