原发性脑干病变BAEP与CT、MRI对比研究

The Control Study of BAEPS,CT,MRI in Patients with Primary Brain Stem Diseases

目的：探讨ＣＴ、ＭＲＩ、ＢＡＥＰ对脑干病变诊断的敏感性及ＢＡＥＰ与脑干病损严重程度和预后的关系。方法：对３２例脑干病变的患者同时进行了ＣＴ、ＭＲＩ及ＢＡＥＰ检查，并对患者进行格拉斯哥昏迷计分（ＧＣＳ）及神经功能缺损评分（ＳＳＳ）。根据ＢＡＥＰ异常情况分为３组：Ⅰ组：ＢＡＥＰ正常组；Ⅱ组：ＢＡＥＰ异常或双侧不对称，但各波存在；Ⅲ组：除Ⅰ波外，其余各波消失。病后３月对患者进行预后评价。结果：脑干病变ＣＴ阳性率５３１３％，ＭＲＩ阳性率９０６２％，ＢＡＥＰ阳性率３４３８％。ＭＲＩ及ＢＡＥＰ阳性率高于头颅ＣＴ，有显著性差异，Ｐ＜００５。Ⅰ组及Ⅱ组患者ＧＣＳ计分高于Ⅲ组，ＳＳＳ评分低于Ⅲ组。Ⅲ组患者全部预后不良，与Ⅰ组及Ⅱ组比较有显著差异，Ｐ＜００５。结论：对脑干病变ＭＲＩ和ＢＡＥＰ阳性率较高，若同时进行ＭＲＩ和ＢＡＥＰ检查达１００％；ＢＡＥＰ是判断脑干病变严重程度及预后较为可靠的指标。

Objective:To explore the sensitivity of CT,MRI and BAEP on brain stem diseases and the relationship among BAEPS,degree of brain stem injury and prognosis.Methods:The CT,MRI and BAEP were examined in 32 patient with brain stem diseases.The GCS Score and SSS score were performed on all patients.Basis on BAEPS,the patients were divided into three groups:group Ⅰ:normal BAEPS;group Ⅱ:abnormal BAEPS or asymmetrical BAEPS,but without any ware was missing,and group Ⅲ:all waves were disappeared besides wave Ⅰ.Results:The positive rate of CT,MRI,BAEPS was 53 13%,90 62%,84 38%,respectivily.The positive rate of MRI and BAEPS was significantly higher than that of CT( P <0 05).The GCS score of group Ⅰ and Ⅱ was higher than that of group Ⅲ,The SSS score of group Ⅰ and group Ⅱ was lower than that of group Ⅲ.All patients in group Ⅲ had a poor prognosis.Conclusion:The sensitivity of MRI or BAEPS was higher in patients with brain stem diseases.The sensitivity was 100% if both MRI and BAEP were performed.BAEPS were an important index reflecting the degree of brain stem injury and its prognosis.