磁共振成像联合脑脊液检测对中枢神经感染的鉴别诊断效果

Effect of magnetic resonance imaging combined with cerebrospinal fluid test on differential diagnosis of central nervous system infection

目的探究磁共振成像(MRI)联合脑脊液(CSF)检测在诊断和鉴别中枢神经感染中的临床价值。方法选取2013年1月-2016年1月于医院治疗164例中枢神经系统感染患者和52例头疼患者,将164例感染患者分为病毒性脑膜炎组88例、结核性脑膜炎组45例、化脓性脑膜炎组31例,将52例头疼患者作为对照组,对四组患者磁共振成像、脑脊液中的乳酸脱氢酶(LDH)、乳酸(LA)、肌酸激酶(CK)、C-反应蛋白(CRP)、神经元特异性烯醇化酶(NES)和γ-感染素(IFN-γ)指标含量进行检测分析。结果病毒性脑膜炎组、结核性脑膜炎组和化脓性脑膜炎组磁共振成像检测结果为阳性患者分别为82例、44例、31例,已感染三组阳性检出率与对照组阳性检出率比较有显著的统计学意义(P<0.05);乳酸脱氢酶含量水平最高的是结核性脑膜炎组患者,与化脓性脑膜炎组患者乳酸脱氢酶含量相比差异有统计学意义(P<0.05),和其余两组患者乳酸脱氢酶含量相比差异有统计学意义(P<0.05),肌酸激酶含量水平最高是化脓性脑膜炎组患者,与结核性脑膜炎组患者肌酸激酶含量水平相比差异有统计学意义(P<0.05),与其余两组患者肌酸激酶含量相比差异有统计学意义(P<0.05),病毒性脑膜炎组患者神经元特异性烯醇化酶含量水平最高,与其余三组患者神经元特异性烯醇化酶含量相比差异有统计学意义(P<0.05)。结论磁共振成像对诊断中枢神经感染具有很高的临床应用价值,脑脊液对鉴别中枢神经感染具有较高的临床应用价值,两者联合对中枢神经感染诊断和鉴别具有良好的效果。

OBJECTIVE To explore the clinical value of magnetic resonance imaging（MRI）combined with cerebrospinal fluid（CFS）test in differential diagnosis of central nervous system infection.METHODS Totally 164 patients with central nervous system infection and 52 headache patients who were treated in the hospital from Jan 2013 to Jan 2016 were enrolled in the study.The 164 patients with infection were divided into the viral meningitis group with 88 cases,the tubercular meningitis group with 45 cases and the purulent meningitis group with 31cases;the52headache patients were set as the control group.The MRI findings and the levels of CSF lactate dehydrogenase（LDH）,lactic acid（LA）,creatine kinase（CK）,C-reactive protein（CRP）,neuron specific enolase（NSE）,and interferon-γ（IFN-γwere observed and compared among the four groups.RESULTS There were 82 patients with positive result of MRI in the viral meningitis group,44 patients in the tubercular meningitis group,and 31 patients in the purulent meningitis group.There was significant difference in the positive detection rate between the three infection groups and the control group（P〈0.05）.The LDH level was the highest in the tubercular meningitis group,and there was significant difference in the LDH level between the tubercular meningitis group and the purulent meningitis group（P〈0.05）,as compared with other two groups,there was significant difference in the LDH level（P〈0.05）.The CK level was the highest in the purulent meningitis group,and there was significant difference in the CK level between the purulent meningitis group and the tubercular meningitis group（P〈0.05）,as compared with other two groups,and there was significant difference in the CK level（P〈0.05）.The NSE level was highest in the viral meningitis group,as compared with other three groups,there was significant difference in the NSE level（P〈0.05）.CONCLUSIONThe MRI has high clinical value in diagnosis of the central venous system infection,the CSF test has high clinical value in identification of the central nervous system infection,and the combination of the two can achieve remarkable effect on differential diagnosis of the central nervous system infection.