医学教学课件：Radiology of CNSInfection

1、Radiology of CNS Infection,Infections,Intracranial infections include abscess, meningitis and encephalitis. Infections can be caused by pyogenic, tuberculous, viral or parasitic organisms. They may lie within brain parenchyma, the subdural or epidural spaces or may involve compartment. CT and MRI pl

2、ay important roles in the early diagnosis of infections.,Pyogenic Meningitis,Bacterial meningitis,Haemophilus Influenzae type B (Hib),Meningococcus,Pneumococcus,Etiological agents? -leading causes (2/3),No. 1,No. 2,No. 3,(Epidemic cerebrospinal meningitis),Clinical findings of meningitis,Signs and s

3、ymptoms Fever Headache Altered mental status - lethargy to coma Neck stiffness Increased intracranial pressure - nausea/vomiting, bulging fontanelle in infants, papilledema 视乳头水肿 Meningeal irritation - Nuchal rigidity and Brudzinskis and Kernigs signs (+),Imaging Findings,Frequently hematogenous spr

4、ead CT/MRI No abnormal findings Hydrocephalus +C : prominent meningeal enhancement Complications : ventriculitis (ependymitis), subdural empyema, infarction,meningeal enhancement meningeal thickening and prominent enhancement granulomas: node or ring enhancement, T2WI: low SI , multiple small or lar

5、ge nodules. Vasculitis infarction hydrocephalus,结核性脑膜脑炎 颅底池明显 可影响脑池脑沟内CSF循环，引起脑积水 结核瘤 脑膜，脑实质，有特征性（短T2） 结核性脑脉管炎 血管狭窄，引起脑缺血，脑梗塞,Tuberculosis of CNS,Tuberculous meningitis,Tuberculous meningitis Diffuse intense enhancement in the suprasellar cistern, sylvian C “病灶中的病灶”“靶状”：病灶双重信号 脑干、小脑、视神经、脊髓受累；脑萎缩. +C: 急性期/新鲜病灶常出现强化, 实质性或 环状强化. 激素治疗后强化减少或消失.,M S case,M S case,M S case,M S case 2,M S case 2,MS - Case 3,MS with optic neuritis,M S,“Subcortical U fibres”,Juxta-cortical lesions,Juxta-cortical lesions,Juxta-cortical lesions,Tongji Hospital,MS,鉴别