功能磁共振对于病毒性脑炎及颅内结核的诊断价值研究  

Diagnostic Value of Functional Magnetic Resonance Imaging in Viral Encephalitis and Intracranial Tuberculosis

作　　者：谷聚贤[1] 户红伟 姚彦 刘超[3] GU Ju-xian;HU Hong-wei;YAO Yan;LIU Chao(Department of Neurology,Cangzhou Central Hospital,Cangzhou 061011,Hebei Province,China;Department of Sports Medicine,Cangzhou Central Hospital,Cangzhou 061011,Hebei Province,China;Department of CT Diagnosis,Cangzhou Central Hospital,Cangzhou 061011,Hebei Province,China)

机构地区：[1]沧州市中心医院神经内五科,河北沧州061011 [2]沧州市中心医院运动医学科,河北沧州061011 [3]沧州市中心医院CT诊断科,河北沧州061011

出　　处：《中国CT和MRI杂志》2024年第6期31-33,60,共4页Chinese Journal of CT and MRI

基　　金：河北省2021年度医学科学研究课题计划(20211127)。

摘　　要：目的探讨功能磁共振对于病毒性脑炎(VE)及颅内结核(IT)的诊断价值。方法选取我院2021年1月-2022年12月收治的VE患者48例、IT患者41例、亚急性脑梗死患者50例、低级别胶质瘤患者50例纳入研究。所有患者均行常规MRI、三维动脉自旋标记(3D-ASL)、弥散加权成像(DWI)及氢质子MR波谱分析(~1H-MRS)成像扫描。观察比较VE、IT、亚急性脑梗死和低级别胶质瘤四组患者的ADC值、rCBF值和1H-MRS结果。结果IT患者的平均ADC值较正常对照区ADC值升高,而VE患者、亚急性脑梗死和低级别胶质瘤三组的平均ADC值均较正常对照区ADC值减低。IT患者rADC均高于VE患者、亚急性脑梗死患者和低级别胶质瘤患者,以VE患者和亚急性脑梗死患者最为显著(P<0.05)。低级别胶质瘤患者的平均rCBF较正常对照区rCBF升高,而IT患者和亚急性脑梗死患者的平均rCBF均较正常对照区rCBF减低,其中亚急性脑梗死患者降低最明显,而VE患者平均rCBF较正常对照区稍降低。低级别胶质瘤患者rrCBF均高于VE患者.、IT患者和亚急性脑梗死患者,以亚急性脑梗死患者最为显著(P<0.05)。低级别胶质瘤患者的Cho/Cr和Cho/NAA比值明显高于VE患者、IT患者、亚急性脑梗死患者(P<0.05)。VE患者的Cho/Cr和Cho/NAA比值低于IT患者(P<0.05)。结论ADC值、rCBF值、Cho/Cr和Cho/NAA比值对VE和IT的诊断和鉴别诊断能提供重要信息,有助于治疗方案及预后情况的判断。Objective To explore the diagnostic value of functional magnetic resonance imaging(fMRI)in viral encephalitis(VE)and intracranial tuberculosis(IT).Methods Forty-eight patients with VE,41 patients with IT,50 patients with subacute cerebral infa rction and 50 patients with low-grade glioma admitted to our hospital from January 2021 to December 2022 were included in the study.All patients underwent conventional MRI,three-dimensional a rterial spin labeling(3D-ASL),diffusion-weighted imaging(DWI)and hydrogen proton MR Spectroscopy(~1H-MRS)imaging.The ADC values,rCBF values and~1H-MRS results of VE,IT,subacute cere b ral infa rction and low-grade glioma groups we re observed and compared.Results The mean ADC values in IT patients were higher than those in the normal control area,while the mean ADC values in VE patients,subacute cerebral infarction and low-grade glioma patients were lower than those in the normal control area.rADC in IT patients was higher than that in VE patients,subacute cerebral infa rction patients and low-grade glioma patients,and the most significa nt difference was found in VE patients and subacute cerebral infa rction patients(P<0.05).The average rCBF of patients with low-grade glioma was higher than that of the normal control a rea,while the average rCBF of patients with IT and subacute cerebral infa rction was lower than that of the normal control area,and the average rCBF of patients with subacute cerebral infa rction was the most obvious reduction,while the average rCBF of patients with VE was slightly lower than that of the normal control area.The rrCBF of low-grade glioma patients was higher than that of VE patients,IT patients and subacute cerebral infa rction patients,and the subacute cerebral infa rction patients we re the most significant(P<0.05).The Cho/Cr and Cho/NAA ratios in low-grade glioma patients were significantly higher than those in VE patients,IT patients and subacute cerebral infarction patients(P<0.05).The Cho/Cr and Cho/NAA ratios in VE patients were lower than those in

关 键 词：功能磁共振 病毒性脑炎 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] R529.3[医药卫生—诊断学]