脑脊液及颅脑MRI增强扫描对颅内结核的诊断价值研究  

Study on diagnostic value of cerebrospinal fluid and craniocerebral MRI enhanced scan on intracranial tuberculosis

作　　者：纪俊雨[1] 申静[1] 袁帅[1] 赵宇明[1] JI Jun-yu;SHEN Jing;YUAN Shuai(Department of Radiology,Hebei Chest Hospital,Shijiazhuang 050041,Hebei Province,China;不详)

机构地区：[1]河北省胸科医院放射科,河北石家庄050041

出　　处：《中国医学装备》2022年第5期60-63,共4页China Medical Equipment

基　　金：河北省医学科学研究重点课题计划(20170430)“颅内结核的MRI演变及与脑脊液检查的相关性研究”。

摘　　要：目的:研究脑脊液、颅脑磁共振成像(MRI)增强扫描对颅内结核的诊断价值。方法:对医院收治的400例颅内结核患者进行分析,所有患者均行脑脊液检查及MRI平扫、增强扫描,分析患者脑脊液改变及MRI影像学表现。结果:400例颅内结核患者中,MRI平扫检查异常患者292例,诊断阳性率为73%;增强扫描检查异常患者341例,诊断阳性率为85.25%;脑脊液检测异常患者305例,诊断阳性率为76.25%。MRI增强扫描诊断阳性率高于脑脊液检测,差异有统计学意义(x^(2)=10.422,P<0.05),两者联合诊断阳性率(91.00%)高于MRI、脑脊液单项诊断,差异有统计学意义(x^(2)=6.319,x^(2)=31.776;P<0.05);MRI及脑脊液检测对颅内结核诊断存在一致性,且一致性良好(Kappa=0.619,P<0.05)。结论:颅脑MRI及脑脊液检查各具侧重点,且一致性良好,可相互补充,对临床脑脊液检测阴性的疑似病例行MRI增强扫描,可提高诊断准确率,为颅内结核的诊断鉴别提供可靠证据。Objective:To explore the diagnostic value of cerebrospinal fluid and craniocerebral magnetic resonance imaging(MRI)enhanced scan on intracranial tuberculosis.Methods:400 patients with intracranial tuberculosis who admitted to hospital were retrospectively analyzed.All patients underwent cerebrospinal fluid examination,MRI plain scan and enhanced scan,and the changes of cerebrospinal fluid and MRI imaging performance were analyzed.Results:In the 400 patients with intracranial tuberculosis,292 cases were abnormal as MRI plain scan and the diagnostically positive rate was 73%,and 341 cases were abnormal as enhanced scan and the diagnostically positive rate of MRI was 85.25%.And 305 cases were abnormal as the examination of cerebrospinal fluid and the positive rate of that was 76.25%.The positive rate of enhanced MRI scan was significantly higher than that of the examination of cerebrospinal fluid(x^(2)=10.422,P<0.05).And the positive rate(91.00%)of combined diagnosis of two methods was significantly higher than each single diagnosis of them(x^(2)=6.319,x^(2)=31.776,P<0.05).There was a consistency between MRI and cerebrospinal fluid examination in the diagnosis of intracranial tuberculosis,which had favorable consistency(Kappa=0.619,P<0.05).Conclusion:Craniocerebral MRI and cerebrospinal fluid examination have respective focus and the consistency of them are favorable,which can complement each other.The enhanced MRI scan which is underwent on suspected cases with negative results of clinically cerebrospinal fluid examination can improve diagnostic accuracy,which can provide reliable evidence for the diagnosis and differentiation of intracranial tuberculosis.

关 键 词：脑脊液 磁共振成像(MRI) 增强扫描 颅内结核 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学]