探析结核性脑膜炎诊断中多层螺旋CT与MRI检查的应用价值

Application Value of MSCT and MRI in the Diagnosis of Tuberculous Meningitis

目的研究在结核性脑膜炎诊断中应用多层螺旋CT与MRI检查的临床价值。方法研究对象为广州市胸科医院收治的结核性脑膜炎患者60例(2016年10月—2017年10月期间),全部患者均行多层螺旋CT与MRI检查,记录两种检查方式的准确率,并研究分析检查的影像特点。结果 MRI检查准确率显著高于多层螺旋CT检查(91. 67%> 71. 67%),差异有统计学意义(P <0. 05)。经多层螺旋CT平扫发现大部分患者存在脑积水、脑梗死等异常症状,并表现为等密度或等高密度影像改变,部分伴钙化;增强扫描后发现多数表现为环状或是结节状强化现象,少数则不强化。MRI检查发现患者脑池与脑底均出现不同程度的闭塞现象,甚至有患者脑底部脑池形态已消失,T1加权与T2加权分别表示稍高信号、等信号;增强扫描可发现多数受累脑膜呈串珠样、点状及斑片状强化,少数不强化。结论多层螺旋CT与MRI检查均可为结核性脑膜炎患者的诊断提供重要依据,但两种检查方式比较,MRI检查准确率更高,更具临床应用价值。

Objective To study the clinical value of multi-slice spiral CT and MRI in the diagnosis of tuberculous meningitis.Methods60patients with tuberculous meningitis from October,2016to October,2017were the research objects.All patients were checked by multi-slice CT and MRI.Inspection accuracy of two methods were recorded,and the image characteristics of inspection were researched.Results The accuracy of MRI examination was significantly higher than that of MSCT(91.67%>71.67%),and the difference was statistically significant(P<0.05).Multi-slice spiral CT plain scan showed that most patients had abnormal symptoms such as hydrocephalus and cerebral infarction,etc,and showed changes in isodensity or isodensity images,some of which were accompanied by calcification.After enhanced scanning,most of them showed ring or nodular enhancement,while a few were not.Brain MRI found that there were different levels of occlusion phenomenon in patients with brain pool bottom,even cerebral brain pool at the bottom of the form has disappeared.T1weighted and T2weighted slightly high signal,such as signal,respectively.Enhanced scanning revealed that most of the affected cerebral membranes were beaded,dotted and patchy with few unenhanced ones.Conclusion Both MSCT and MRI examination can provide an important basis for the diagnosis of tuberculous meningitis patients,but compared with the two methods,the accuracy of MRI examination is higher and it has more clinical application value.