脑囊虫病影像诊断.pptx

Case Discussion By Head Group 2013-5-9 History Female,48Y Sudden onset;headache, nausea and vomit for 10 years; aggravation for 1 day CSF culture(－) 2013-1-2 2013-1-15 2013-1-22 Diagnosis Cerebral Cysticercosis epidemiology most commonly in the whole body cysticercosis(80％) most commonly in cerebral parasitic disease more prevalent in the country Pathogen: the cysticercus of armed tapeworm classification Parenchymal Ventricular(the third or fourth) Meningeal Mixed periodization Subclinical stage Active stage Degeneration and death stage Calcification stage Mixed stage Imaging Active stage small excentric spotty shadow of the mural cysticercus scolex low signals on T1WI,high signals onT2WI capsular liquid : higher than CSF on FLAIR unremarkable peripheral edema Degeneration and death stage scolex disappearance enlarged capsular cavity remarkable peripheral edema “white/black target sign” “multi-ring sign” “delanminated sign” Calcification stage lower signals on T1WI and T2WI peripheral edema disappearance Mixed stage Enhanced scanning:ringlike enhancement DDX Intracranial tuberculosis Metastatic encephaloma Brain abscess intracranial tuberculosis Children and youth Classification tuberculous meningitis tuberculoma tuberculous brain abscess IMAging Tuberculous meningitis hydrocephalus distention of subarachnoid spaces abnormal meningeal and cistern enhancement Tuberculoma space-occupying effect hydrocephalus calcification “target sign” ringlike or eggshell-like enhancement Metastatic encephaloma Primary leision(lung,braest,melanoma) Multiple Supratentorial(80％)，subtentorial(20％) Cortex-medullary junctions Imaging Isointensity on T1WI Iso- or mildly hypointensity on T2WI “small nodule and big edema” sign necrosis and cystic degeneration obvious nodular or ringlike enhancement Brain abscess Supratentorial(temporal lobe) Pathogen:MRSA,streptococcus,pneumococcus Periodization