颅脑术后发生颅内感染的CT和MRI改变及其诊断价值分析

发布时间：2018-03-25 13:46

本文选题：颅内感染　切入点：CT　出处：《中华医院感染学杂志》2017年09期

【摘要】：目的探讨颅脑术后发生颅内感染的CT和MRI改变及其诊断价值,为临床诊治提供参考依据。方法选取医院神经外科2013年1月-2015年12月行颅脑术后发生颅内感染患者共67例,对患者的临床资料进行分类整理,由两位高年资主治医师对患者住院期间所做的CT及MRI检查图像进行评估和诊断,分析比较颅脑术后发生颅内感染患者的CT和MRI改变及颅内感染患者诊断的准确率。结果 CT结果显示,患者中正常结果35例(52.24%),异常结果32例(47.76%);32例CT异常图像主要表现弥漫性脑水肿、多发散在的斑块状低密度灶(金黄色葡萄球菌13例、表皮葡萄球菌7例、溶血葡萄球菌6例),18例增强后病灶及其周围呈高密度强化;MRI结果显示,患者中正常结果11例(16.42%),异常结果56例(83.58%);56例MRI异常图像主要表现为不规则多发性长T1、长T2信号病灶(金黄色葡萄球菌25例、表皮葡萄球菌18例、溶血葡萄球菌10例),22例增强后病灶及其周围呈高信号强化。MRI检查颅内感染患者阳性诊断率明显高于CT组,差异有统计学意义(P0.01);CT组早期发生异常者26例(38.81%),后期异常者9例(13.43%);MRI组早期异常58例(86.57%),后期异常者23例(34.33%),MRI组阳性诊断率明显高于CT组(P0.05),差异有统计学意义。结论 MRI和CT技术对颅内感染患者的诊断及治疗具有重要作用,同时MRI对颅内感染患者的确诊作用更大,提高了诊断的准确率。
[Abstract]:Objective to investigate the CT and MRI changes of intracranial infection after craniocerebral surgery and its diagnostic value, and to provide reference for clinical diagnosis and treatment. Methods 67 patients with intracranial infection after craniocerebral surgery from January 2013 to December 2015 were selected. The clinical data of the patients were sorted out, and the CT and MRI images performed during the hospitalization were evaluated and diagnosed by two senior attending physicians. Ct and MRI changes in patients with intracranial infection after craniocerebral operation were analyzed and compared. The normal results were 52.24% in 35 cases, and the abnormal results were 47.76% and 47.76% in 32 cases with diffuse cerebral edema and diffuse plaque type low-density foci (13 cases of Staphylococcus aureus, 7 cases of Staphylococcus epidermidis, 3 cases of diffuse cerebral edema and 7 cases of Staphylococcus epidermidis). In 6 cases of Staphylococcus haemolyticus, 18 cases showed high density enhanced MRI. Among the patients, 11 cases had normal results, 56 cases had abnormal results, 56 cases had abnormal MRI images, and 56 cases showed irregular long T 1, long T 2 signal lesions (Staphylococcus aureus 25 cases, Staphylococcus epidermidis 18 cases). The positive diagnostic rate of 10 cases of Staphylococcus haemolyticus with intracranial infection was significantly higher than that of CT group. The difference was statistically significant in 26 cases with early abnormal P0.01T, 9 cases with late abnormal in 13.43C group, 58 cases with early abnormality and 23 cases with late abnormality with P0.055.Conclusion the positive rate of MRI in MRI group is significantly higher than that in CT group (P 0.05). And CT technique has important role in the diagnosis and treatment of intracranial infection. At the same time, MRI plays a more important role in the diagnosis of intracranial infection, and improves the accuracy of diagnosis.
【作者单位】：宁波市第一医院影像科;
【基金】：宁波市社发基金资助项目(2015H0009)
【分类号】：R445.2;R651.1;R816.1

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