Objective To investigate the clinical features and magnetic resonance imaging (MRI)characteristics of tuberculous meningitis in children. Methods The clinical features and MRI findings of 28 children with tubercu-lous meningitis, who were hospitalized between 2012 and 2014, were retrospectively analyzed. Results The age of patients ranged from 3 months to 16 years old, including 6 case less than 1 years old, 4 of 3 years old, 2 of 7 years old, and 16 of 16 years old. Clinical features:25 cases of fever, 16 of headache, 10 of vomiting, 6 of convulsions, 5 of cough, 2 of abdominal pain, 1 of unconsciousness, 1 of fatigue, and 1 of neck mass. Six cases underwent PPD test:positive in 3 cases and negative in 3 cases. Thirteen cases underwent Pan′s test: positive in 12 cases and negative in 1 case. The Mycobacterium tuberculosis was found in the cerebrospinal fluid, sputum or gastric juice in 4 cases. Tu-berculous meningitis accompanied with tuberculosis other parts of the body was found in 26 cases (26/28), including 4 of systemic multiple tuberculosis, 5 of miliary pulmonary tuberculosis, and 17 of other pulmonary tuberculosis. MRI findings: 20 cases of basilar cistern changes (20/28); 21 of intracranial tuberculoma (21/28); 7 of cerebral atrophy (7/28); 4 of cerebral infarction (4/28); 22 of hydrocephalus (22/28), including 12 of mild, 5 of moderate and 5 of severe. Effective anti-tuberculosis treatment was found in 21 cases. Six cases in critical condition gave up treatment (3 of se-vere hydrocephalus and 3 of cerebral infarction). One case was not treated and discharged. Conclusion Tuberculous meningitis in children shows complicated clinical features and low positive rate of laboratory examination. MRI exam-ination may identify the location, distribution, characteristics of the lesion, degree of hydrocephalus, and the occur-rence of cerebral infarction and brain atrophy, which is useful in the protocols of clinical treatment, and evaluation of prognosis.%目的：探讨小儿结核性脑膜炎的临床特点及磁共振成像（MRI）特征性表现。方法对2012—2014年收治的28例小儿结核性脑膜炎的临床特点及MRI表现进行回顾性分析。结果发病年龄3个月至16岁，其中＜1岁6例，~3岁4例，~7岁2例，~16岁16例；临床表现：发热25例、头痛16例、呕吐10例、抽搐6例、咳嗽5例、腹痛2例、意识障碍1例、乏力1例、颈部包块1例；结核菌素纯蛋白衍生物（PPD）试验6例：阳性3例，阴性3例；潘氏试验13例：阳性12例，阴性1例；在脑脊液、痰液或胃液中找到结核分支杆菌者4例；同时伴有身体其他部位结核26例（26/28）：其中全身多发结核4例，粟粒肺结核5例，其他肺结核17例；MRI表现：基底池改变20例（20/28；）颅内结核瘤21例（21/28）；脑萎缩7例（7/28）；脑梗死4例（4/28）；脑积水22例（22/28）：其中轻度12例、中度5例、重度5例；经抗结核治疗有效者21例，病情危重放弃治疗6例（重度脑积水3例，脑梗死3例），未治疗出院1例。结论小儿结核性脑膜炎临床表现多样，实验室检查阳性率较低，MRI检查能够了解病灶的部位、分布、特性，脑积水的程度，脑梗死及脑萎缩的发生等，对临床治疗方案的选择及预后的评估有指导意义。
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