影像所见
CT
- 右侧前部基底节/右侧内囊前肢及右侧额叶皮层下白质低密度区，伴轻度对应局部占位效应
MRI
- 双侧大脑半球及小脑半球多灶性脑实质弥散受限
- 最大病灶位于右侧前部基底节/右侧内囊前肢，大小约3 x 2.5 x 2.3 cm，表现为环形强化，沿室管膜缘强化不完整，中央弥散受限
- 线状强化沿右侧侧脑室上缘延伸
- 许多病灶表现为周围磁敏感伪影
- 周围血管源性水肿，尤以右侧基底节和右侧额叶皮层下病灶为著
- 无明显中线移位或脑疝、脑积水征象
带注释的图像和插图
Peripherally-enhancing lesion with central restricted diffusion in the right basal ganglia and internal capsule (red arrows), highly concerning for a pyogenic abscess. Close proximity to the ventricular margin increases the risk for ventriculitis.
Although this case is not the best example of an abscess rim, there is a thin T2 and SWI hypointense rim (red arrows) with a thin internal SWI hyperintense ring (yellow arrow).
Enhancement extending along the superior margin of the right lateral ventricle (red arrow), which raises concern for developing ventriculitis.
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脓毒性栓子伴化脓性脑脓肿
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