![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=1738887674-h7q1Qraec3ETPXVPp6OcSfT7BbJ12eJ6-0-857e42bc37be6c6370943dc8818da270)
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=1738887674-6neUuthAIhgIkYMA5XohyBx7H8w4u6Jn-0-abb561aafe70f62fdd0a76c8a4a5f706)
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=1738887674-QbpuCCT2DXlRje8L4K397mcKJym3Mtyz-0-6e47448a7e0ed4c57e031f9644d7afc8)
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=1738887674-QYvAYq9XpoveCHGHnwv6q945MBDiwRMk-0-f1ff1c36f51278df00030586ffffd61d)
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=1738887674-NVOerBAvwFFQacDlHpOXDmjMgjtpkl4t-0-2f4d4fc0abe219da3615724e9cad63e1)
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=1738887674-IMyZZ45nqmw6x27mCXX00SAwKMgCKiaO-0-dcec91a9fb6916eb016a25147455baa1)
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=1738887674-b5UsP4XgNC70I3q84utSVrhW32oSFbVc-0-758398d0add5629cb570cf8a169f74b4)
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=1738887674-kWkaD0lYwSbCowfcMF3e9RIRyGOWDsRz-0-9b5ef879dc4585b82a591eb842f7d39d)
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=1738887674-z3XzLbZeLvTbkVT31jx3OI8DqNFl6F3s-0-8fed9ede0e7e9301301b884d9de3abf4)
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=1738887674-Phg5RGwSdU2ZpP1yYFJVmxSlM6bz5v51-0-fa8e484b4cd8568f139d70a693f6fc6d)
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=1738887674-PmlYtsqKgZS9CwABTfCoLHWhW4zt8mLl-0-76cceaaf0a49ee40b799ad22edd48c36)
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=1738887674-pfk5MToG5yo2TjVz7Jbj9s0rzC49ytsp-0-c111050af2b99e33ade442e39cb84234)
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