磁共振DWI在中枢神经系统结核合并缺血性脑卒中的诊断效能  

Diagnostic Efficacy of Magnetic Resonance DWI in Central Nervous System Tuberculosis Combined with Ischemic Stroke

作　　者：袁光峰 方伟军[1] 任婉莹 张晖[1] 唐城 李蔚宇[1] YUAN Guangfeng;FANG Weijun;REN Wanying(Department of Radiology,Guangzhou Chest Hospital,Guangzhou City,Guangdong Province510095)

机构地区：[1]广东省广州市胸科医院放射科,510095

出　　处：《医学理论与实践》2023年第16期2701-2703,2707,共4页The Journal of Medical Theory and Practice

基　　金：广州市高水平临床重点专科和培育专科建设项目(穗卫函[2019]155号)。

摘　　要：目的:探讨弥散加权成像(DWI)在中枢神经系统结核合并缺血性脑卒中诊断中的效能。方法:回顾性分析疑似中枢神经系统结核合并缺血性脑卒中患者60例磁共振DWI及其ADC图,并结合T_(2)FLAIR辅助诊断。以病理检查结果作为“金标准”,比较中枢神经系统结核合并缺血性脑卒中患者不同b值缺血灶区DWI信号强度和ADC值。结果:60例疑似患者术后病理确诊41例。缺血灶DWI高b值诊断灵敏度、特异度、阳性及阴性预测值高于中低b值检查(P<0.05);随着b值升高,患者DWI信号强度值呈下降趋势,不同b值信号强度值具有统计学意义(P<0.05);阳性患者低中高b值结核病灶信号强度高于阴性患者(P<0.05)。结论:DWI高b值用于中枢神经系统结核合并缺血性脑卒中患者中具较高的检出率、灵敏度和特异度。Objective:To investigate the efficacy of diffusion-weighted imaging(DWI)in the diagnosis of CNS tuberculosis combined with ischemic stroke.Methods:DWI and ADC maps in 60 patients of suspected CNS tuberculosis with ischemic stroke were combined with T_(2)FLAIR to assist diagnosis.Pathological findings were used as the“gold standard”to compare the DWI signal intensity and ADC values in different b values in patients with CNS TB complicated with ischemic stroke.Results:41 cases were confirmed in 60 suspected patients.The diagnostic sensitivity,specificity,positive and negative predictive values with high b values were higher than moderate and low b values(P<0.05);with higher b values,DWI signal intensity values decreased,and different b values were statistically significant(P<0.05);positive patients with low and high b values were higher than negative patients(P<0.05).Conclusion:DWI high b value is used for high detection rate,sensitivity and specificity in patients of CNS tuberculosis combined with ischemic stroke.

关 键 词：MRI DWI 中枢神经系统结核 缺血性脑卒中 ADC值 

分 类 号：R445[医药卫生—影像医学与核医学]