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MRI影像分析左侧小 脑蛛网膜囊肿鉴别 诊断中的应用*

作者:沈 洋 蒋耀峰

所属单位:南京中医药大学附属南京市中西结 合医院神经外科 (江苏 南京 210014)

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摘要

目的 探讨左侧小脑蛛网膜囊肿 的MRI表现,用以指导临床诊断及鉴别诊 断。方法 选取2009年9月至2011年9月的 100例左侧小脑蛛网膜囊肿患者,分别对 其进行常规MRI扫描以及增强扫描,并结 合常规核磁共振序列,分析左侧小脑蛛网 膜囊肿MRI表现并与手术结果对照。结果 100例检查者均采用MRI影像分析,常规扫 描确诊44例,增强扫描确诊48例,增强扫 描的确诊率高达96%,比常规扫描高。结 论 MRI在左侧小脑蛛网膜囊肿的鉴别与诊 断中具有非常高的应用价值,可以作为左 侧小脑蛛网膜囊肿术前的首选检查方法。

Objective To explore the MRI features of the left cerebellar cysts of the cerebellum, and to guide the clinical diagnosis and differential diagnosis. Methods In September 2009 to September 2011, 100 cases of arachnoid cyst of the left cerebellar patients, separately carries on the conventional MRI scanning and enhanced scanning, combined with conventional MRI sequences and analysis of left cerebellum arachnoid cyst MRI findings and the results were compared with surgery. Results 100 cases were examined by MRI image analysis, 44 cases were diagnosed by routine scan, 48 cases were confirmed by enhanced scan, the diagnosis rate of enhanced scan was as high as 96%, higher than that of conventional scanning. Conclusion MRI has very high application value in the diagnosis and differentiation of the left cerebellar cyst of the cerebellum. It can be used as the first choice for the diagnosis of the left cerebellar cyst.

【关键词】MRI影像分析;小脑蛛网膜; 囊肿

【中图分类号】R445.2;R739.4

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.10.002

前言

左小脑蛛网膜囊肿的病因和病理和颅内其他部位的蛛网膜囊肿相 同:按蛛网膜囊肿的病因可以我们可以将其分为原发性和继发性两大 类[1];按蛛网膜囊肿的病理可以将其分为蛛网膜内囊肿和蛛网膜下囊 肿两大类。左小脑蛛网膜囊肿和其他颅内蛛网膜囊中一样都具有生长 缓慢和较强的代偿功能,它表现出的临床症状也十分复杂,包括眼球 震颤、共济失调等[2]。   当前医学界对小脑蛛网膜囊肿的研究越来越多,但在其发病机 制、临床特征、鉴别与诊断等方面仍存在着非常多的争议。关于其治 疗方面的手术指征及手术方式也是目前较为有争议的焦点之一。随着 影像学设备的普遍运用,颅内囊肿的发现率也出现上升趋势。左小脑 蛛网膜囊肿多见于青年,患者常因外伤后经影像学检查发现,也可能 因囊肿扩大或出血而产生的临床症状而发现。因此尽早明确诊断对于 提高患者的生活质量和治愈率具有非常重要的意义。本文通过对100例 左小脑蛛网膜囊肿患者进行分析,探讨左侧小脑蛛网膜囊肿的MRI表 现,用以指导临床诊断及鉴别诊断[3]。