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颅脑结核诊断中MRI磁敏感SWI技术的运用探究

来源:用户上传      作者:袁光峰,张晖,唐城

  摘要:目的:探MRI磁敏感加权成像(SWI)技术在颅脑结核患者中的诊断效果及价值。方法:选择2018年1月至2021年1月疑似颅脑结核患者60例为研究对象,所有患者入院后均给予MRI磁敏感SWI技术和普通增强扫描,并将其与结核菌培养、涂片及病理检查“金标准”进行比较,分析MRI磁敏感SWI技术下颅脑结核的检出率、诊断效能及影像学特点。结果:60例疑似颅脑结核患者确诊45例;MRI增强扫描检查确诊38例,诊断灵敏度为66.67%(30/45)、特异度为46.67%(7/15);MRI磁敏感SWI技术检查确诊42例,诊断灵敏度为84.44%(38/45)、特异度为73.33%(11/15);MRI磁敏感SWI技术检查联合MRI普通增强确诊44例,诊断灵敏度为93.33%(42/45)、特异度为86.67%(13/15);45例最终确诊的患者中,42例MRI磁敏感SWI技术下颅底脑池或(和)脑表面脑膜不规则斑片状、线样增厚,且增强后明显强化;7例伴有积水,5例多发腔隙性脑梗死,增强后未见明显强化,MRI磁敏感SWI技术下呈等信号。结论:MRI磁敏感SWI技术用于颅脑结核患者中具有较高的检出率,联合MRI普通增强扫描诊断灵敏度及特异度较高,具备典型的影像学特点,能为临床诊疗提供参考依据。
  关键词:MRI磁敏感SWI技术;颅脑结核;结核菌培养;病理检查;诊断效能
  中图分类号:R445.4 文献标识码:B DOI:10?郾3969/j.issn.1001-0270.2022.01.11
  Exploration of the Application of MRI Magnetic Sensitive SWI Technology in the Diagnosis of Craniocerebral Tuberculosis
  YUAN Guang-feng, ZHANG Hui, TANG Cheng
  (Guangzhou Chest Hospital, Guangdong 510095, China)
  Abstract: Objective: To investigate the diagnostic effect and value of MRI susceptibility weighted imaging(SWI) technology in patients with craniocerebral tuberculosis. Methods: From January 2018 to January 2021, 60 patients with suspected craniocerebral tuberculosis were selected as subjects. After admission, all patients were given MRI magnetically sensitive SWI technology and ordinary enhanced scanning, and were cultured with tuberculosis, smear and pathology. Check the "gold standard" for comparison, and analyze the detection rate, diagnostic efficiency and imaging characteristics of craniocerebral tuberculosis under MRI magnetic sensitivity SWI technology. Results: 60 cases of suspected craniocerebral tuberculosis patients were diagnosed with 45 cases; MRI enhanced scanning was diagnosed in 38 cases, with a diagnostic sensitivity of 66.67%(30/45) and a specificity of 46.67%(7/15); MRI magnetically sensitive SWI technology confirmed the diagnosis For 42 cases, the diagnostic sensitivity was 84.44%(38/45) and the specificity was 73.33%(11/15); 44 cases were diagnosed by MRI magnetic sensitivity SWI technique combined with MRI general enhancement, and the diagnostic sensitivity was 93.33% (42/45) , The specificity was 86.67% (13/15); among the 45 patients who were finally diagnosed, 42 of them were irregular patch-like and linear thickening of the brain cistern or (and) the meninges on the brain surface under the MRI magnetic sensitive SWI technique. And there was obvious enhancement after enhancement; 7 cases were accompanied by hydrops, 5 cases had multiple lacunar infarctions, no obvious enhancement was seen after enhancement, and the MRI magnetically sensitive SWI showed iso-signals. Conclusion: MRI magnetically sensitive SWI technology has a high detection rate in patients with craniocerebral tuberculosis, combined with MRI general enhanced scanning, has high diagnostic sensitivity and specificity, and has typical imaging characteristics, which can provide a reference for clinical diagnosis and treatment.
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