增强T_(2)FLAIR序列的视觉评估与定量分析在评估单纯疱疹病毒性脑炎患者中的应用价值  

The Value of Visual Evaluation and Quantitative Analysis of Contrast-Enhanced T_(2)FLAIR Sequence in the Assessment of Herpes Simplex Encephalitis

作　　者：谭娜 周祥 王祥杰 王荣品[2] 余倩[2] 徐睿[3] TAN Na;ZHOU Xiang;WANG Xiangjie(Graduate School of Zunyi Medical University,Zunyi,Guizhou Province 563006,P.R.China)

机构地区：[1]遵义医科大学研究生院,563006 [2]贵州省人民医院放射科,贵阳550002 [3]贵州省人民医院神经内科,贵阳550002

出　　处：《临床放射学杂志》2025年第2期231-236,共6页Journal of Clinical Radiology

基　　金：贵州省卫健委科学技术基金项目(编号:gzwkj2022-183);中华国际医学交流基金会2021SKY影像科研基金项目(编号:Z-2014-07-2101);贵州省高层次创新型人才培养计划项目(编号:GZSYQCC【2023】009)。

摘　　要：目的探讨对比增强T_(2)液体衰减反转恢复(CE-T_(2)FLAIR)序列的视觉评估及定量分析在评估单纯疱疹病毒性脑炎(HSE)患者中的应用价值。方法回顾性搜集2021年1月至2023年12月确诊的HSE患者,且颅脑MRI检查存在异常者共33例,基于改良Rankin量表评分(mRS)分为轻症组(18例)和重症组(15例)。所有患者均接受1.5 T MR扫描,搜集增强前、后T_(2)FLAIR序列。由两名影像科医师基于增强前、后T_(2)FLAIR序列图像对病灶进行视觉评估,最终结果由两名高年资医师共同商议决定。另由两名医师于每例HSE患者最大病灶的最大层面上勾画感兴趣区(ROI),定量测量对比度(CR)、增强百分比值(PI),取两名医师所测结果的平均值为最终结果。采用SPSS 29.0统计软件包进行数据分析,评价两位医师视觉评估结果的一致性并比较组间差异,比较两组间每例HSE患者最大病灶的CR值、PI值的差异,绘制受试者工作特征(ROC)曲线,分析CR值、PI值对病情严重程度的诊断效能。结果视觉评估共纳入113个病灶,42个病灶呈正强化,3个病灶呈负强化,68个病灶呈等强化,不同组间比较差异无统计学意义(P>0.05,Fisher精确检验);定量分析共纳入每例HSE患者最大病灶共33个,其中轻症组18个,重症组15个。CR值测量显示轻症组、重症组平均CR值分别为50.56±23.13、32.56±25.28,不同组间CR值比较差异具有统计学意义(t值为2.823,P<0.01)。PI值测量显示轻症组、重症组平均PI值分别为6.33±4.83、-4.41±6.67,不同组间PI值比较差异具有统计学意义(t值为5.296,P<0.0001)。CR值的曲线下面积(AUC)为0.7754,约登指数、敏感度和特异度分别为157.29、81.82%、76.47%。PI值的AUC为0.9167,约登指数、敏感度和特异度分别为173.6、85.71%、88.89%。结论CE-T_(2)FLAIR序列可作为一种简单、经济便捷的影像学方法用于评估HSE患者病情严重程度,其视觉评估无法区分轻、重症组患者,而定量指�Objective To explore the value of visual evaluation and quantitative analysis of contrast-enhanced T_(2)-fluid-attenuated inversion recovery(CE-T_(2)FLAIR)sequences in the simplex virus encephalitis(HSE)patients.Methods In total 33 patients with HSE confirmed by Guizhou Provincial People's Hospital from January 2021 to December 2023 and with abnormalities on cranial MRI were retrospectively analyzed.Based on the modified Rankin scale(mRS),the patients were divided into a mild group(18 cases)and a severe group(15 cases).All patients underwenT_(1).5 T MR,and the parameters of T_(2)FLAIR sequence were collected before and after enhancement.Visual evaluation of the lesion was performed by two imaging physicians based on pre-and post-contrast enhanced T_(2)FLAIR sequences,and the final results were determined by the two senior physicians.Two imaging physicians defined the region of interest(ROI)at the largest lesion in each HSE patient,quantitatively measuring the contrast ratio(CR)and percentage increase(PI).The average of their results was used as the final outcome.SPSS 29.0 statistical software package was used to analyze the data and evaluate the consistency of the two physicians'visual evaluation and the measurement of CR and PI,and to compare the differences between groups.The receiver operating characteristic(ROC)curve was plotted,and the diagnostic efficacy of CR value and PI value on the severity of the disease was analyzed.Results A total of 113 lesions were included in the visual evaluation,42 lesions showed positive enhancement,3 lesions showed negative enhancement,and 68 lesions showed equal enhancement.There was no significant difference between the different groups(P>0.05,Fisher's exact test).A total of 33 lesions with the largest number were included in the quantitative analysis,including 18 in the mild group and 15 in the severe group.The mean CR values of mild group and severe group was 50.56±23.13 and 32.56±25.28,respectively.There were significant differences in CR value between different groups(

关 键 词：T_(2) FLAIR 磁共振成像 对比增强 单纯疱疹病毒性脑炎 血脑屏障 

分 类 号：R73[医药卫生—肿瘤]