本文選題：顱內(nèi)感染　切入點(diǎn)：CT　出處：《中華醫(yī)院感染學(xué)雜志》2017年09期

【摘要】：目的探討顱腦術(shù)后發(fā)生顱內(nèi)感染的CT和MRI改變及其診斷價(jià)值,為臨床診治提供參考依據(jù)。方法選取醫(yī)院神經(jīng)外科2013年1月-2015年12月行顱腦術(shù)后發(fā)生顱內(nèi)感染患者共67例,對(duì)患者的臨床資料進(jìn)行分類整理,由兩位高年資主治醫(yī)師對(duì)患者住院期間所做的CT及MRI檢查圖像進(jìn)行評(píng)估和診斷,分析比較顱腦術(shù)后發(fā)生顱內(nèi)感染患者的CT和MRI改變及顱內(nèi)感染患者診斷的準(zhǔn)確率。結(jié)果 CT結(jié)果顯示,患者中正常結(jié)果35例(52.24%),異常結(jié)果32例(47.76%);32例CT異常圖像主要表現(xiàn)彌漫性腦水腫、多發(fā)散在的斑塊狀低密度灶(金黃色葡萄球菌13例、表皮葡萄球菌7例、溶血葡萄球菌6例),18例增強(qiáng)后病灶及其周?chē)矢呙芏葟?qiáng)化;MRI結(jié)果顯示,患者中正常結(jié)果11例(16.42%),異常結(jié)果56例(83.58%);56例MRI異常圖像主要表現(xiàn)為不規(guī)則多發(fā)性長(zhǎng)T1、長(zhǎng)T2信號(hào)病灶(金黃色葡萄球菌25例、表皮葡萄球菌18例、溶血葡萄球菌10例),22例增強(qiáng)后病灶及其周?chē)矢咝盘?hào)強(qiáng)化。MRI檢查顱內(nèi)感染患者陽(yáng)性診斷率明顯高于CT組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);CT組早期發(fā)生異常者26例(38.81%),后期異常者9例(13.43%);MRI組早期異常58例(86.57%),后期異常者23例(34.33%),MRI組陽(yáng)性診斷率明顯高于CT組(P0.05),差異有統(tǒng)計(jì)學(xué)意義。結(jié)論 MRI和CT技術(shù)對(duì)顱內(nèi)感染患者的診斷及治療具有重要作用,同時(shí)MRI對(duì)顱內(nèi)感染患者的確診作用更大,提高了診斷的準(zhǔn)確率。
[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.
【作者單位】： 寧波市第一醫(yī)院影像科;
【基金】：寧波市社發(fā)基金資助項(xiàng)目(2015H0009)
【分類號(hào)】：R445.2;R651.1;R816.1

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