![MRI鉴别诊断一点通](https://wfqqreader-1252317822.image.myqcloud.com/cover/826/25793826/b_25793826.jpg)
三、脑血管及感染性疾病鉴别诊断
1.颅内出血各期的鉴别诊断
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image86.jpeg?sign=1739349741-FzmvbejNdryq2RvsFzz8nxLzGyuZzlHa-0-f1027cc1f02d7fb2f5a86317088ed4c4)
图1-3-1 超急性期颅内出血MRI表现
右侧基底节区可见斑片状T1WI稍低、T2WI高信号灶(→),边界模糊, T2WI灶周可见条状水肿带,右侧脑室前角受压、闭塞
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image87.jpeg?sign=1739349741-sXSehu57E0yUxN50Kam4VBAtHCHrHdEA-0-0deffa9f620a4c94cabe8bef7cc637e9)
图1-3-2 急性期颅内出血MRI表现
左基底节区斑片状信号灶(→),表现为T1WI稍低信号,T2WI低信号,灶周可见斑片状水肿带
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image88.jpeg?sign=1739349741-2Lnd4fDZQmADRlmjHOQmd0JWaeNWnhAl-0-163ed707e5d7c913d9b4f980b226f7e7)
图1-3-3 亚急性期颅内出血MRI表现
左侧基底节区斑片状信号灶,表现为T1WI、T2WI高信号改变(→),灶周少量斑片状水肿带及含铁血黄素沉积
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image89.jpeg?sign=1739349741-w8vh6IM6fRdOMXDaBXN8sESJSc5vIQO1-0-a6889fa5aace7e0a953752bb746907e7)
图1-3-4 慢性期颅内出血MRI表现
左侧基底节区可见长T2信号灶(→),与脑脊液信号类似,边界清晰,灶周可见T2WI低信号含铁血黄素环沉积()
2.血管性脑白质病变与多发性硬化鉴别诊断
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image91.jpeg?sign=1739349741-8KNnRUUHyyrnYpSjGo4xwTJWkCHSUHS2-0-f0ba08af48b33e670803d44c96dd08cc)
图1-3-5 血管性脑白质病变MRI表现
双侧半卵圆区、侧脑室旁白质可见多发斑片状长T2信号灶(→),边界模糊,脑沟脑裂增宽
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image93.jpeg?sign=1739349741-nKyOz5maaZGkU4UBy9YFZKZLJkL0PNl9-0-aecec47a573a758e2be61b68ad35eff6)
图1-3-6 多发性硬化MRI表现
双侧侧脑室体部、前后角旁可见多发斑片状长T1、长T2信号灶,近室管膜下区分布(→);增强扫描部分病灶环形强化
3.脑脓肿分期的鉴别诊断
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image95.jpeg?sign=1739349741-83ZKuemOqervCBJlGytq6iUeVP0Elhmb-0-b41c9e4e8e367bd7da64411b7968c8fe)
图1-3-7 脑脓肿脑炎期MRI表现
双侧大脑半球多发斑片状长T2高信号灶(→),边界模糊,DWI病灶高信号
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image96.jpeg?sign=1739349741-UYh9r9zfwVkQg8EHUT0l2lBxvPJfZFeR-0-9fd714a6da1c4bd1625e39bc2ee0ab80)
图1-3-8 脑脓肿包膜形成期MRI表现
左侧颞叶可见大片状水肿带,其内可见囊性病灶(→),T2WI囊壁低信号,囊内高信号,增强扫描环形强化,内壁光整。DWI呈高信号,提示其内蛋白积聚,水分子弥散受限
4.脑感染性疾病的鉴别诊断
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image98.jpeg?sign=1739349741-rYXD3hbQHdRAZv22zWKgsj6GQ8rTJi76-0-17098897856f89226f822e4742fe5d6e)
图1-3-9 脑结核MRI表现
脑干、颞叶及小脑可见多发类圆形结节状及环状等及稍低T2信号灶(→),灶周可见斑片状水肿带;增强扫描可见多发小环形强化灶()
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image99.jpeg?sign=1739349741-cYRVuRqlTB6JBxeokjSGw3eMT31lsvfC-0-0957a06fe3ae37c52515a4e3b14bac08)
图1-3-10 病毒性脑炎MRI表现
左侧岛叶可见斑片状稍长T2信号灶(→),边界模糊,DWI呈高信号改变,提示弥散受限,T1WI增强扫描显示病灶局部轻度条带状强化
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image101.jpeg?sign=1739349741-rBJyxRat0GQc0Ifv3mXpQd4JBTmCp6b9-0-afa233ba8d5618ffa21e25a0397f3807)
图1-3-11 脑囊虫病MRI表现
左侧顶叶可见斑片状水肿带(→),其内可见小囊性病灶(),增强扫描显示小环形强化
![](https://epubservercos.yuewen.com/ACF619/14262447305041006/epubprivate/OEBPS/Images/image102.jpeg?sign=1739349741-j2kSBjY9jzq1CpHYPX0d84yTSM9GSAbH-0-6a1bde4bd34a59d9c11c5abdb725b9c0)
图1-3-12 脑棘球蚴病MRI表现
左侧顶叶T1WI囊性低信号灶(→),囊壁信号稍高,增强扫描囊壁轻微强化(→),同侧脑室受压