MRI常规序列+DWI+SWI联合NSE对成人低血糖脑病的诊断价值研究

Diagnostic Value of Conventional MRI Sequence+DWI+SWI Combined with NSE in Adult Hypoglycemic Encephalopathy

目的探究磁共振成像(Magnetic Resonance Imaging,MRI)常规序列+扩散加权成像(Diffusion Weighted Imaging,DWI)+磁敏感加权成像(Susceptibility Weighted Imaging,SWI)联合神经元特异性烯醇化酶(Neuron Specific Enolase,NSE)对成人低血糖脑病的诊断价值。方法选取2018年8月至2019年8月经我院病理学检查确诊的低血糖脑病患者60人,对所有患者均进行MRI常规序列+DWI+SWI、MRI常规序列+DWI+SWI联合NSE进行检测,同时选取于我院进行健康体检的患者60人作为健康组,对健康组受试者使用MRI常规序列+DWI+SWI联合NSE进行检测。使用酶联免疫吸附法对C反应蛋白(C-Reactive Protein,CRP)、NSE、S-100B进行检测,比较两种检查手段对成人低血糖脑病的检出情况、漏诊、误诊率及诊断效能。结果与健康组相比,低血糖脑病组CRP、NSE、S-100B水平从0.95 mg/L、2.03 ng/mL、6.31 mg/L上升至18.71 mg/L、24.41 ng/mL、46.51(P<0.05);与健康组相比,低血糖脑病组基底节区表观弥散系数值从1.09下降至0.45,胼胝体压部的SDC值从0.99下降到0.35,差异有统计学意义(P<0.05);MRI常规序列+DWI+SWI联合NSE诊断灵敏度、特异度、准确性均高于高频MRI常规序列+DWI+SWI检测(P<0.05);MRI常规序列+DWI+SWI联合NSE检测漏诊率、误诊率低于高频MRI常规序列+DWI+SWI检测(P<0.05)。结论较于MRI常规序列+DWI+SWI检测检测,使用MRI常规序列+DWI+SWI联合NSE进行检测,检测的检出率、诊断灵敏度、准确性更高,诊断效能更加理想。

Objective To explore the diagnostic value of conventional magnetic resonance imaging(MRI)sequence+diffusion weighted imaging(DWI)+susceptibility weighted imaging(SWI)combined with neuron specific enolase(NSE)in adult hypoglycemic encephalopathy.Methods From August 2018 to August 2019,60 patients with hypoglycemia encephalopathy confirmed by pathological examination were selected.All patients were examined by conventional MRI sequence+DWI+SWI,conventional MRI sequence+DWI+SWI combined with NSE.At the same time,60 peoples were selected for physical examination in our hospital as a healthy group,and MRI routine sequence+DWI+SWI combined with NSE was used to detect the healthy group.C-reactive protein(CRP),NSE and S-100B were detected by enzyme-linked immunosorbent assay.The detection,missed diagnosis,misdiagnosis rate and diagnostic efficacy of the two methods were compared.Results Compared with the healthy group,the levels of CRP,NSE and S-100B in the hypoglycemic encephalopathy group increased from 0.95,2.03 and 6.31 to 18.71,24.41 and 46.51(P<0.05).Compared with the healthy group,the basal ganglia apparent dispersion coefficient value of the hypoglycemia encephalopathy group decreased from 1.09 to 0.45,and the SDC value of the compression part of the corpus callosum decreased from 0.99 to 0.35,with statistically significant differences(P<0.05).The diagnostic sensitivity,specificity and accuracy of conventional MRI sequence+DWI+SWI in combined with NSE were higher than those of conventional high-frequency MRI sequence+DWI+SWI(P<0.05).The rate of missed diagnosis and misdiagnosis of conventional MRI+DWI+SWI combined with NSE was lower than that of high frequency conventional high-frequency MRI+DWI+SWI(P<0.05).Conclusion Compared with the conventional MRI sequence+DWI+SWI detection,conventional MRI sequence+DWI+SWI combined with NSE detection has higher detection rate,diagnostic sensitivity,accuracy and better diagnostic efficiency.