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1、儿童结核性脑膜炎CT影像临床研究作者:金周徳，闫世明,张慧荣【关键词】儿童【摘要】冃的探讨CT扫描对儿童结核性脑膜炎的诊断价值。方法210例儿童结核性脑膜炎，CT平扫210例，增强126例，130例患儿复查2〜4次。结果CT正常22例，异常188例，显示有7种病变类型分别是渗出性病变99例(47.1%),脑积水115例(54.8%),结核球51例(24.3%),脑萎缩40例(19.0%),脑血管炎及脑梗死26例(12.3%),硬膜下积液12例(5.7%),钙化11例(5.2%),其中一种病变者82例(43.5%),以渗出病变、脑积水、结核球占多数，两种病变同时存在者75例
2、(40.3%),3种病变同时存在者31例(16.2%),以渗出性病变合并脑积水、结核球或脑积水合并脑萎缩、脑梗死居多。结论CT在诊断儿童结核性脑膜炎病变部位范围和程度提供准确的诊断依据及对预后估计治疗效果判断具有非常重要价值。渗出性病变是儿童结脑最主要及特征性表现，脑积水及局灶状脑梗死为其典型表现，脑沟增宽可作为脑萎缩早期的唯一征象，增强CT显示脑膜血管异常强化及结核球敏感性明显高于CT平扫。结脑所致脑积水的程度与病程成正比，与患儿的年龄成反比。关键词儿童结核脑膜X线计算机体层摄影术ClinicalstudyofCTimageinchildrenwithtuberculo
3、sismeningitisJinZhoude,YanShiming,ZhangHuirongDepartmentofIntegration,ChangchunInfectionsHospital,川in130062・【Abstract】ObjectiveTodeterminethediagnosticvalueofCTscanninginchildrenwithtuberclosismeningi-tis.Methods210childrenwithtuberculosismeningitisunderwentCTscan.PlainCTscanweredonein21O
4、patients.126patientswereperformedcontrastenhancementCTscanning.130ofthemwerecheckedagain2to4times.ResultsNormalCTscanningwerefoundin22cases,188caseswereabnormal.Thisseriesincluded7typesofmanifestation:exudativelesion(n=99,47.1%),hydrocephalus(n=l15,54.8%),tuberculomas(n=51,24.3%),encephal
5、atrophy(n=40,19.0%),cerebralvasculitisandinfarctions(n=26,12.3%),subduraleffusion(n=12,7.5%),calcifica-tion(n=ll,5.7%).Abovethese,82patients(43.5%)hadonelesion,thelesionincludingexudativelesion,hydro-cephalus,tuberculomas,75patients(40.3%)hadtwolesions,thatincludingexudativelesionandhydro
6、cephalus,tuber-culomas/hydrocephalus,encephalatrophyorinfarction,31patients(16.2%)hadthreelesions,thatincludingexudativelesion,encephalatrophyandinfarction.ConclusionCTcanprovideanaccuratediagnosisforjudgingthelocationanddegreeofthelesionsinchildrenwithtuberculosismeningitis,especiallyitp
7、laysaveryimportantroleinevaluatingprognosisandcurativeeffect.Exudativelesionisthemostcharacteristicmanifestationsinchildrenwithtuberculosismengitis.Theonlyearlysymptomofencephalatrophyisconvolutionbroaden.ComparedwithplainCTscanning,corntrastenhancementCTscancanreve
