CT和磁共振成像在小儿脑性瘫痪诊断中的价值对比分析

Comparative analysis of CT and MRI in the diagnosis of cerebral palsy in children

目的研究X线计算机体层成像(X-ray computed tomography,CT)和磁共振成像(magnetic resonance imaging,MRI)对小儿脑性瘫痪诊断的诊断价值。方法在2018年5月至2020年5月抽取148例小儿脑性瘫痪患儿,随机分组,CT组的74例开展CT检查,MRI组的74例开展MRI检查,2组均开展病理学检查,观察2组检查准确率。结果MRI组阳性检出率为97.3%(72例),CT组阳性检出率为87.0%(64例),MRI组阳性检出率更高,差异具有统计学意义,(χ^(2)=5.8039,P=0.0160)。MRI组的74例小儿脑性瘫痪患儿经病理学检查后,脑积水检出率为32.4%(24例),脑膜炎检出率为20.3%(15例),脑缺血检出率为23.0%(17例),脑白质异常检出率为24.3%(18例)。CT组的74例小儿脑性瘫痪患儿经病理学检查后,脑积水检出率为29.7%(22例),脑膜炎检出率为24.3%(18例),脑缺血检出率为20.3%(15例),脑白质异常检出率为25.7%19例。MRI组漏诊率为2.7%(2例),检出准确率为94.6%(70例),CT组漏诊率为13.5%(10例),准确率为75.7%(56例),MRI组漏诊率低,准确率高,差异具有统计学意义,(χ^(2)=5.8039,10.4646,P=0.0160,0.0012)。MRI组中有1例脑白质异常患儿被误诊为脑缺血;CT组中有1例脑积水患儿被误诊为脑膜炎,有1例脑积水患儿被误诊为脑缺血。结论在小儿脑性瘫痪诊断中,MRI检查准确率较高,还能对脑性瘫痪类型进行分型,误诊漏诊率较低,较CT检查更值得推广。

Objective To study the diagnostic value of X-ray computed tomography(CT)and magnetic res-onance imaging(MRI)in the diagnosis of cerebral palsy in children.Methods From May 2018 to May 2020,148 children with cerebral palsy were selected and divided into two groups.74 patients in the CT group underwent CT examination,74 patients in the MRI group underwent MRI examination.Both groups developed pathology check and observe the accuracy of the two groups.Results The positive detection rate in the MRI group was 97.3%(72 cases),and the positive detection rate in the CT group was 86.5%(64 cases).The positive detection rate in the MRI group was higher and the difference was obvious(χ^(2)=5.8039,P=0.0160).In the MRI group,74 children with cerebral palsy had pathological examination,the detection rate of hydrocephalus was 32.43%(24 cases),the detection rate of meningitis was 20.3%(15 cases),and the detection rate of cerebral ischemia It was 23.0%(17 cases),and the detection rate of abnormal white matter was 24.3%(18 cases).In the CT group of 74 children with cerebral palsy,after pathological examination,the detection rate of hydrocephalus was 29.7%(22 cases),the detection rate of meningitis was 24.32%(18 cases),and the detection rate of cerebral ischemia was 20.3%(15 cases),and the detection rate of abnormal white matter was 25.7%(19 cases).The missed diagnosis rate in the MRI group was 2.7%(2 cases),the detection accuracy rate was 94.6%(70 cases),the missed diagnosis rate in the CT group was 13.5%(10 cases),the accuracy rate was 75.7%(56 cases),and the missed diagnosis rate in the MRI group Low,high accuracy and obvious difference(χ^(2)=5.8039,10.4646,P=0.0160,0.0012).One child with abnormal white matter in the MRI group was misdiagnosed as cerebral ischemia,one child with hydrocephalus in the CT group was misdiagnosed as meningitis,and one child with hydrocephalus was misdiagnosed as cerebral ischemia.Conclusion In the diagnosis of cerebral palsy in children,MRI examination can achieve a higher accuracy rate,and it can also clarify the type of cerebral palsy.The rate of misdiagnosis and missed diagnosis is lower,which is more popular than CT examination.