关键词: 脑结核, 脑转移瘤, 磁共振成像, 动态增强, 细节表现, 比较分析

Abstract: Objective To analyze the detailed features of contrast-enhanced MRI in patients with brain parenchymal tuberculosis and metastasis,and explore the similarities and differences between the two. Method A retrospective analysis of 72 cases of brain parenchyma tuberculosis（research group） clinically diagnosed in Guangzhou Chest Hospital from January 2019 to December 2020,at the same time, 72 patients (control group) with brain metastases who met the inclusion criteria in the same period were collected for comparative analysis,the matching principle was the same sex and age difference within 2 years. Through the comparison of the detailed signs of enhanced MRI in the two groups,objective to analyze the detailed features of brain parenchyma tuberculosis on enhanced MRI. Result ①Multiple lesions of brain parenchyma tuberculosis（research group）: 65 cases (90.28%);when the focus was < 0.3cm,it mainly enhanced by the whole nodule, the detection rate in this group was 22 cases (35.56%);when the focus was ≥0.3cm,it mainly annular strengthening,the detection rate in this group was 58 cases (80.56%). ②In the research Group,the detection rates of lustered enhancement, no enhanced low signal ring around the lesion, uniform thickness of annular enhancement wall, small central partition, and mild central enhancement ring (ring in the ring) were 30.56%(22/72), 44.44%(32/72), 63.89%(46/72), 38.89(28/72)、16.67%(12/72) respectively; In the control group, they were 13.89%(10/72), 23.61%(17/72), 31.94%(23/72), 16.67%(12/72), 4.17%(3/72) respectively;The difference between the two groups was statistically significant（All P<0.05）.In the control group,the detection rates of uneven thickness of annular enhanced wall and inner wall nodules were 61.11%(44/72) and 30.56%(22/72) respectively;In the study group,they were 38.89%(28/72)、 8.33% (6/72) respectively;The difference between the two groups was statistically significant(χ²=7.111、11.350,P=0.008、0.001 respectively). Conclusion Multiple lesions was the main manifestations of cerebral tuberculosis,when the focus was <0.3cm, the enhancement of the whole nodule was the main manifestation,when the focus was ≥0.3cm, annular enhancement was the main manifestation.The enhanced MRI scanning of brain parenchyma tuberculosis was easier to detect clustered enhancement, no enhanced low signal ring around the lesion, uniform thickness of annular enhancement wall, small central partition, and mild central enhancement ring (ring in the ring).The enhanced MRI scan of brain metastasis was easier to detect the uneven thickness of annular enhanced wall and the inner wall nodule.Both have their own detailed signs of enhanced MRI,it can provide help for early clinical diagnosis and treatment.

Key words: Brain tuberculosis, Brain metastases, Magnetic resonance imaging, Dynamic enhancement, Detailed features, Comparative analysis