头颅CT与磁共振成像对急性血行播散型肺结核并发结核性脑膜炎的诊断价值比较  

Comparison of diagnostic value of head CT and magnetic resonance imaging for acute hematogenous disseminated pulmonary tuberculosis complicated with tuberculous meningitis

作　　者：李清华[1] 刘新[1] 李健康 赵畅 吴寒[1] 刘继伟[1] 丁成智[1] 梁瑞霞[1] LI Qinghua;LIU Xin;LI Jiankang;ZHAO Chang;WU Han;LIU Jiwei;DING Chengzhi;LIANG Ruixia(Henan Provincial Chest Hospital/Henan Clinical Medical Research Center of Tuberculosis,Zhengzhou 450008,Henan Province,China)

机构地区：[1]河南省胸科医院/河南省结核病临床医学研究中心,河南郑州450008

出　　处：《新乡医学院学报》2022年第8期772-776,共5页Journal of Xinxiang Medical University

摘　　要：目的比较头颅CT与头颅磁共振成像(MRI)对急性血行播散型肺结核(HDPT)并发结核性脑膜炎(TBM)的诊断价值。方法选择2012年7月至2019年5月河南省胸科医院收治的50例急性HDPT并发TBM患者为研究对象,患者均行头颅CT平扫、MRI平扫和增强扫描,比较头颅CT平扫、MRI平扫和增强扫描对急性HDPT并发TBM的诊断阳性率。结果头颅CT平扫对急性HDPT并发TBM的诊断阳性率为72.0%(36/50),对早期急性HDPT并发TBM的诊断阳性率为12.5%(1/8);头颅MRI平扫对急性HDPT并发TBM的诊断阳性率为84.0%(42/50),对早期急性HDPT并发TBM的诊断阳性率为62.5%(5/8);头颅MRI增强扫描对急性HDPT并发TBM的诊断阳性率为96.0%(48/50),对早期急性HDPT并TBM的诊断阳性率为87.5%(7/8)。MRI增强扫描对急性HDPT并发TBM的诊断阳性率显著高于MRI平扫和头颅CT平扫(χ^(2)=4.000、10.714,P<0.05),MRI平扫对急性HDPT并发TBM的诊断阳性率显著高于头颅CT平扫(χ^(2)=4.320,P<0.05)。MRI平扫和增强扫描对早期急性HDPT并发TBM的诊断阳性率显著高于颅脑CT平扫(χ^(2)=4.270、9.000,P<0.05),MRI平扫与增强扫描对早期急性HDPT并发TBM的诊断阳性率比较差异无统计学意义(χ^(2)=2.620,P>0.05)。结论头颅MRI检查对急性HDPT并发TBM的临床诊断阳性率高于头颅CT,尤其是对早期急性HDPT并发TBM患者的诊断阳性率更高。Objective To compare the diagnostic value of head CT and magnetic resonance imaging(MRI)for acute hematogenous disseminated pulmonary tuberculosis(HDPT)complicated with tuberculous meningitis(TBM).Methods A total of 50 patients with actue HDPT complicated with TBM admitted to Henan Provincial Chest Hospital from July 2012 to May 2019 were selected as the study subjects.All patients underwent head CT plain scan,MRI plain scan and MRI enhanced scan.The positive rate of CT plain scan,MRI plain scan and MRI enhanced scan in diagnosis of acute HDPT complicated with TBM was compared.Results The positive rate of head CT plain scan in diagnosis of acute HDPT complicated with TBM was 72.0%(36/50),and the positive rate of head CT plain scan in diagnosis of early acute HDPT complicated with TBM was 12.5%(1/8);the positive rate of MRI plain scan in diagnosis of acute HDPT complicated with TBM was 82.0%(41/50),and the positive rate of MRI plain scan in diagnosis of early acute HDPT complicated with TBM was 50.0%(4/8);the positive rate of MRI enhanced scan in diagnosis of acute HDPT complicated with TBM was 96.0%(48/50),and the positive rate of MRI enhanced scan in diagnosis of early acute HDPT complicated with TBM was 87.5%(7/8).The positive rate of MRI enhanced scan in diagnosis of acute HDPT complicated with TBM was significantly higher than that of MRI plain scan and head CT scan(χ^(2)=4.000,10.714;P<0.05),the positive rate of MRI plain scan in diagnosis of acute HDPT complicated with TBM was significantly higher than that of head CT plain scan(χ^(2)=4.320,P<0.05).The positive rate of MRI plain scan and enhanced scan in diagnosis of early acute HDPT complicated with TBM was significantly higher than that of CT plain scan(χ^(2)=4.270,9.000;P<0.05),and there was no significant difference in the positive rate in diagnosis of early acute HDPT complicated with TBM between MRI plain scan and MRI enhanced scan(χ^(2)=2.620,P>0.05).Conclusion The positive rate of MRI in the clinical diagnosis of acute HDPT complicated with TBM

关 键 词：急性血行播散型肺结核 结核性脑膜炎 CT 磁共振成像 

分 类 号：R52[医药卫生—内科学]