儿童中枢神经系统感染行脑CT检查的价值分析

Evaluation of brain CT examination in children with central nervous system infection

目的探讨脑CT检查对儿童中枢神经系统感染的诊断效果,结合临床实际分析其应用价值。方法选取2015年1月-2016年4月儿童内科收治确诊的中枢神经系统感染患儿48例为研究对象,均排除患有严重心肝肾器质性病变和免疫血液系统疾病,入院后分别行电子计算机断层扫描(CT)、磁共振成像(MRI)检查,重点观察中枢神经系统感染患儿脑CT检查的影像表现,以临床综合确诊结果为金标准并与MRI检查结果比较,观察脑CT检查的诊断效果,综合分析其临床应用价值。结果 48例中枢神经系统感染患儿中CT检查确诊病毒性脑炎15例、结核性脑膜炎8例、脑囊虫病5例、化脓性脑膜炎4例,总确诊率为66.67%,MRI检查病毒性脑炎20例、结核性脑膜炎10例、脑囊虫病6例、化脓性脑膜炎5例,总确诊率为85.42%,两者比较差异有统计学意义(P<0.05);CT对25例细菌性感染确诊率43.48%(10/23),低于MRI检查95.65%(22/23),比较差异有统计学意义(P<0.05),CT、MRI检查23例病毒性感染患儿确诊率分别为88.00%(22/25)、76.00%(19/25),比较差异无统计学意义。结论 CT、MRI均是临床检查中枢神经系统感染的重要手段,MRI诊断效果相对更优;CT在临床应用中检查可根据诊断需要借助MRI检查,优化诊断效果。

OBJECTIVE To investigate the effect of brain CT examination on the diagnosis of central nervous system infection in children,and to analyze its clinical application value.METHODS A total of 48 cases of children with central nervous system infection in Department of Internal Medicine of our hospital from Jan.2015 to Apr.2016 were selected as study objects,and were excluded with severe heart,liver and kidney organic diseases and immune system diseases.Computed tomography（CT）and magnetic resonance imaging（MRI）were carried out after admission,and the brain CT imaging findings in children with central nervous system infection were mainly observed.The clinical comprehensive diagnosis results were chosen as the gold standard and compare the results with MRI examination results,the diagnostic results of brain CT examination were observed,and the clinical application value was comprehensively analyzed.RESULTS In 48 cases of children with central nervous system infection,there were 15 cases of viral encephalitis,8cases of tuberculous meningitis,5cases of cerebral cysticercosis,and 4cases of purulent meningitis by CT diagnosis,and the total positive rate was 66.67%（32/48）;and 15 cases of viral encephalitis,10 cases of tuberculous meningitis,6cases of cerebral cysticercosis,and 5cases of purulent meningitis by MRI examination,and the total positive rate was 85.42%（41/48）.The differences between the two groups were statistically significant（P〈0.05）.The diagnostic rate of 25 cases of bacterial infection by CT was43.48%（10/23）,which was lower than 95.65% by MRI（22/23）,and the differences between the two groups was statistically significant（P〈0.05）.The diagnostic rates of 23 cases of viral infection were respectively88.00%（22/25）and 76.00%（19/25）by CT and MRI respectively,with no significant difference.CONCLUSION CT and MRI are the important clinical examination for central nervous system infection.MRI diagnosis is relatively better effect,and CT can be used with MRI according to the requirement for diagnosis in clinical applications,in order to optimize the diagnostic results.