MSCT联合脑脊液检查对中枢性神经系统感染的诊断鉴别价值  

Differential Diagnostic Value of MSCT Combined with Cerebrospinal Fluid Examinationfor Central Nervous System Infection

作　　者：夏桂丽 李兴鹏[1] 费娅丽 唐英英 李焱昌[1] XIA Gui-li;LI Xing-peng;FEI Ya-li;TANG Ying-ying;LI Yan-chang(Department of Neurology,Sichuan Integrated Traditional Chinese and Western Medicine Hospital,Chengdu 610000,Sichuan Province,China)

机构地区：[1]四川省中西医结合医院神经内科,四川成都610000

出　　处：《中国CT和MRI杂志》2021年第1期28-30,共3页Chinese Journal of CT and MRI

摘　　要：目的探究中枢性神经系统感染诊断鉴别上联用MSCT与脑脊液检查的应用价值。方法回顾性分析2015年12月至2018年12月在我院接受治疗82例中枢性神经系统感染患者以及同期头疼79例患者检查资料,分别作为观察组(n=82)和对照组(n=79),所有患者均接受MSCT以及脑脊液检查。分析观察组患者MSCT检查影像学表现,比较两组患者MSCT检查阳性率、脑脊液检查结果,以及MSCT与脑脊液联合诊断效率。结果观察组患者MSTC检查阳性率(97.80%)显著高于对照组(6.33%)(P<0.05),其中MSCT检查化脓性脑膜炎、结核性脑膜炎、病毒性脑膜炎阳性率分别为80.00%、85.19%和96.67%。化脓性脑膜炎和结核性脑膜炎患者LA、LDH和CK水平均显著高于对照组和病毒性脑炎患者(P<0.05);观察组患者脑脊液中IDN-γ和NSE水平显著高于对照组(P<0.05),而观察组中结核性脑膜炎患者IDN-γ中水平最高,病毒性脑膜炎患者NSE水平最高。MSCT与脑脊液联合用于诊断病毒性脑炎灵敏度较好,诊断化脓性脑膜炎特异度较高,诊断结核性脑膜炎准确度较好。结论MSCT与脑脊液检查从不同方面对中枢性神经系统感染进行有效诊断与鉴别,两者结合可有助于对不同类型中枢性神经系统感染诊断与鉴别。Objective To evaluate the differential diagnostic value of MSCT combined with cerebrospinal fluid examination for central nervous system infection.Methods A retrospective analysis was performed on the examination data of 82 patients with central nervous system infection who were treated in the hospital from December 2015 to December 2018 and 79 patients with headaches during the same period.They were included in the observation group(n=82)and the control group(n=79),respectively.All patients underwent MSCT and cerebrospinal fluid examination.The imaging findings of MSCT in the observation group were analyzed.The positive rate of MSCT examination,cerebrospinal fluid examination results,combined diagnostic efficiency of MSCT,and cerebrospinal fluid were compared between the two groups.Results The positive detection rate of MSTC in the observation group was significantly higher than that in the control group(97.80%vs 6.33%)(P<0.05).The positive rates of MSCT for examining purulent meningitis,tuberculous meningitis,and viral meningitis were 80.00%,85.19%,and 96.67%,respectively.The levels of LA,LDH,and CK in patients with purulent meningitis and tuberculous meningitis were significantly higher than those in the control group and patients with viral encephalitis(P<0.05).Levels of IDN-γand NSE in cerebrospinal fluid of the observation group were significantly higher than those of the control group(P<0.05).In the observation group,levels of IDN-γwere the highest in patients with tuberculous meningitis,NSE levels were the highest in patients with viral meningitis.The sensitivity of MSCT combined with cerebrospinal fluid for diagnosis of viral encephalitis was relatively better,the specificity for the diagnosis of purulent meningitis was relatively higher,and accuracy for diagnosis of tuberculous meningitis was relatively better.Conclusion MSCT and cerebrospinal fluid examination can conduct effective differential diagnosis for central nervous system infections from different aspects.The combination of the two can help

关 键 词：MSCT 脑脊液检查 中枢性神经系统感染 诊断鉴别价值 

分 类 号：R445.3[医药卫生—影像医学与核医学] R338.2[医药卫生—诊断学]