摘要
脑动脉炎和肉芽肿性疾病是中枢神经系统中相对罕见的疾病。由于依据不同而有多种分类形式，其中多种疾病如肉芽肿性动脉炎、中枢性结节病等尚病因不清。由于过去影像学方法的局限性和非特异性，此类疾病不能广泛认识。此组疾病在病理学上存在共同的特征，即血管壁的炎症、坏死、纤维化、管腔狭窄与继发的血栓形成、闭塞及梗死。血管造影是检查此类疾病的最基本方法之一，但不是诊断的“金标准”。它只能显示血管腔的形态学改变，如动脉狭窄。动脉瘤形成和动脉闭塞，而ＣＴ、ＭＲＩ可弥补其不足。ＭＲＩ较为敏感，可显示病变的继发改变，选择特殊的成像序列和参数可显示出血、栓塞、结节、水肿等。同时应用Ｇｄ增强检查，可提供更多的诊断信息，如发现柔脑膜强化等改变。此外，文章中较为详细地介绍了该组疾病中较为常见的类型。据病因的不同，分两大类讲述了感染性和非感染性血管炎中的不同种疾病：细菌性动脉炎、结核性动脉炎、真菌性动脉炎、梅毒性动脉炎和结节性动脉周围炎、肉芽肿性动脉炎、中枢性结节病等。从病因、发病率、基本病理直至相应的影像学表现，特别强调了先进技术ＣＴ、ＭＲＩ、ＭＲＡ对病变显示的优越性。同时，文中亦讲述了系统性红斑狼疮、药瘾、Ｗｈｉｐｐｌｅ病等越来越多见的对?
Arteritis and granulomatious diseases are Telatively rare in the CNS. According to different standards, there are several kinds of classification. The etiology of some diseases, such as granulomatious arteritis, central sarcoidosis, are unknown. In the past, the entities could not be well recognized because of the limitation and non - specificity of imaging methods. The common pathologic characteristics of the entities are inflammation, necrosis and fibrpsis on the wall of blood vessels, stenosis and secondary clot formation, occlusion and infarction. Angiography is one of most basic methods for the entities, but not 'golden standard'. Only the morphological changes of blood vessels, e. g. arterial stenosis, aneurysm and arterial occlusion clould be displayed. CT and MRI could supply more information. MRI is more sensitive to detect secondary changes of lesion. Special sequences and parameters may he help to determine hemorrhage, infarct, nodus and edema, etc. If contrast examination is employed, more useful information, e. g. leptomening enhanced, could he aequired. In addition, the common type of the entities was introduced in details. According to etiology, the arteritis was divided into infectious and non-infectious diseases, which including bacterial arteritis, tubertculosis arteritis, fungal arteritis, syphilic arthritis and polyarteritis nodosa, granulomatous arteritis, central sarcoidosis, etc. The advantage of advanced CT, MRI and MRA was evaluated on aspects of etiology, morbidity, pathology and imaging findings. Systemic lupus erythematosus(SLE), drug abuse and whipple disease which are more than before were also discussed, especially their involvment to CNS. In conclusion, the entities are lack of specifical imaging findings though each disease has their characteristics separately. Clinical manifestation, laboratory examination and epidemicity all are very important to imaging diagnosis.
出处
《中国医学计算机成像杂志》
CSCD
2000年第1期62-69,共8页
Chinese Computed Medical Imaging
