散发性Creutzfeldt-Jakob病病程不同时期的辅助检查敏感性研究

发布时间：2018-04-16 10:15

  本文选题：Creutzfeldt-Jakob病 + 弥散加权成像　； 参考：《解放军医学杂志》2017年05期

【摘要】：目的研究散发性Creutzfeldt-Jakob病(sCJD)患者在病程的不同时期时各项辅助检查手段的敏感性。方法回顾性分析53例sCJD患者的临床资料,统计病程不同时期头颅核磁弥散加权像(DWI)、24h动态脑电图(EEG)、脑脊液14-3-3蛋白及正电子发射计算机断层显像(PET-CT)的敏感性。在计算某一检测手段的敏感性时,以特异性临床表现结合2项或以上辅助检查阳性结果作为诊断的公认标准。结果在53例sCJD患者中,列入病程早期、中期及晚期统计的例数分别为24、53、22例(其中部分患者跨越2或3个时期)。随病程进展,DWI敏感性(早期:58.3%;中期:84.6%;晚期:94.7%)、EEG敏感性(早期:45.8%;中期:62.7%;晚期:77.8%)、脑脊液14-3-3蛋白的敏感性(早期:11.1%;中期:52.9%)及PET-CT的敏感性(早期:80%;中期:100%)均逐渐增高。除晚期未行PET-CT检查外,其他各期PET-CT的敏感性均优于其他辅助检查。结论 sCJD患者在病程不同时期各辅助检查的敏感性不同,在病程不同阶段进行多次复查可提高诊断的敏感性。PET-CT检查的敏感性较高,结合其他检查手段诊断sCJD可起到较为关键的作用。
[Abstract]:Objective to study the sensitivity of adjuvant examination in patients with sporadic Creutzfeldt-Jakob disease at different stages of disease course.Methods the clinical data of 53 patients with sCJD were analyzed retrospectively. The sensitivity of DWI-weighted brain magnetic diffusion weighted imaging (DWI), 14-3-3 protein in cerebrospinal fluid (CSF) and PET-CTs were analyzed.In calculating the sensitivity of a test method, the specific clinical manifestations combined with 2 or more positive results of auxiliary tests are accepted as diagnostic criteria.Results among the 53 patients with sCJD, 22 cases were included in the early, middle and late stage of sCJD.With the progression of the course of the disease, the sensitivity of DWI (early: 94.78.3; mid-stage: 84.6; late: 45.8; mid-stage: 62.7; late: 77.8); the sensitivity of cerebrospinal fluid 14-3-3 protein (early 11.11: 1; mid-stage 52.9) and the sensitivity of PET-CT (early: 80; mid-range: 100th) increased gradually.The sensitivity of PET-CT in other stages was superior to that of other adjuvant examinations except for late PET-CT.Conclusion the sensitivity of various adjuvant examinations in different stages of sCJD patients is different, and repeated reexamination at different stages of the disease course can improve the sensitivity of diagnosis.The diagnosis of sCJD combined with other examination methods can play a more important role.
【作者单位】： 解放军总医院神经内科;
【基金】：解放军总医院“百项优势”项目“中国人亚急性海绵状脑病早期诊疗规范” 解放军总医院2016临床科研扶持基金项目(2016FC-CXYY-1002)~~
【分类号】：R741
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