特異なMRI所見を呈した石灰化頭蓋内結核腫の1例

A Case of Calcified Intracranial Tuberculoma Presenting Unique MRI Findings

I．はじめに

　近年，本邦においては肺結核による死亡率は減少を続けており^11），それに伴って頭蓋内結核腫の頻度も低下している^1,10,19）．しかし，この結核腫もCT導入後のここ数年間，少数例ではあるが症例報告され^{9,14,20,27）}，決して稀な疾患とはいえない．

　最近われわれは粟粒結核罹患後21年目にCTスキャンで左前頭蓋底に石灰化像を発見し，手術により結核腫と診断した1例を経験した．頭蓋内結核腫のMRI所見についての報告は極めて乏しいので，術前MRIの所見を中心にして本症例を報告し，頭蓋内結核腫の治療方針について若干の考察を加える．

A 41-year-old male patient was admitted in our Ryukyu University Hospital complaining of parosmia. He had a history of miliary tuberculosis 21 years ago. Neurologically he showed left anosmia and hyperreflex-ia of the right upper extremity. Plain skull X-P and CT scan revealed a calcified mass, 25mm in diameter, at the left frontal base. In MRI, the mass showed isoin-tensity using the Ti weighted inversion recovery sequ-ence and heterogenously low intensity using the T, weighted spin echo sequence.

Surgery was performed by bifrontal craniotomy. Then the tumor was removed totally including two coexisting small tumors.