脑脓肿患者的感染机制及影像学检查临床意义研究

发布时间：2018-03-26 21:29

本文选题：脑脓肿　切入点：感染机制　出处：《中华医院感染学杂志》2017年07期

【摘要】：目的研究分析脑脓肿患者的感染机制及影像学检查临床意义,探讨弥散加权成像与磁共振波普分析等影像学方法在脑脓肿的临床诊断效果,为临床医师的早期诊断治疗提供一定参考。方法选取医院2012年11月-2016年9月神经外科收治的70例脑脓肿患者,所有患者入院后均行头部CT及MRI平扫联合增强检查,其中44例患者行弥散加权成像检查,5例行磁共振波普分析检查。结果所有患者行常规影像学检查后均显示脑脓肿为包膜期;CT显示脑脓肿边界清晰或为不清晰的类圆形的低密度影,CT增强后可显示边缘区强化,3例患者增强后边缘区强化不明显;MRI显示,T1WI为低信号类圆形病灶,T2WI为高信号,且脓肿边缘可见长T2信号水肿;随访期间对所有患者进行格拉斯哥愈后评分(GOS)评估,70例患者的GOS评分中,5分56例,4分4例,3分4例,1分6例。结论对于脑脓肿患者入院后行常规CT、MRI结合DWI、MRS等检查,可有效提高对脑脓肿诊断准确率,对于脓肿和脑肿瘤的鉴别意义重大。
[Abstract]:Objective to study the infection mechanism and the clinical significance of imaging examination in patients with brain abscess, and to explore the clinical diagnostic effect of diffusion-weighted imaging and magnetic resonance wave analysis in the diagnosis of brain abscess. Methods 70 patients with brain abscess treated by neurosurgery from November 2012 to September 2016 were selected for early diagnosis and treatment. Of the 44 patients, 5 underwent diffusion weighted imaging and 5 underwent MRI. Results after routine imaging, all patients showed brain abscess. Ct showed that the boundary of brain abscess was clear or unclear. The enhancement of the posterior marginal area was not obvious in 3 patients with enhanced marginal area after the enhancement of round low-density CT. MRI showed low signal intensity on T 1WI and high signal intensity on T 2WI. At the edge of abscess, long T2 signal edema was observed. During the follow-up period, all the patients were assessed with Glasgow recovery score (Glasgow scale). The GOS scores of 70 patients were 5 points 56 cases, 4 cases 4 cases, 3 cases 4 cases, 1 point 6 cases. Conclusion the patients with brain abscess were examined with conventional CTMRI and DWII-MRS after admission. It can effectively improve the diagnostic accuracy of brain abscess, and it is of great significance in differentiating abscess from brain tumor.
【作者单位】：庆元县人民医院放射科;丽水市中心医院放射科;
【基金】：浙江省医药卫生科技计划项目(2014KYB361)
【分类号】：R742.7;R816.1

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