CT在老年性痴呆早期诊断过程中的临床应用价值

Clinical Application Value of CT in Early Diagnosis of Senile Dementia

目的:探讨CT在老年性痴呆早期诊断过程中的临床应用价值。方法:选择2020年3月~2021年3月本院收治的45例老年早期痴呆症患者作为痴呆组,另选择同期在本院体检的45例健康人作为同龄健康组。两组受试者均行头颅CT检查,对比两组头颅CT相关测量指标、双侧海马体积和大脑左右径。结果:痴呆组外侧脑裂宽度(0.72±0.23)mm显著低于同龄健康组(1.28±0.29)mm,三脑室宽度(7.29±2.13)mm、尾状核指数(18.56±3.02)%、额角指数(18.56±3.02)%、侧脑室宽度(4.56±0.75)mm、平均脑沟宽度(17.05±3.02)mm、额时脑沟宽度(2.86±1.25)mm显著高于同龄健康组[(4.46±1.79)mm、(11.98±2.56)%、(30.57±4.58)%、(3.05±1.11)mm、(4.61±1.75)mm、(1.58±0.45)mm],差异有统计学意义(P<0.05)。痴呆组右侧海马体积(2.16±0.56)cm^(3)、左侧海马体积(2.14±0.39)cm^(3)和大脑左右径(130.25±8.57)mm均显著低于同龄健康组(2.62±0.48)cm^(3)、(2.53±0.45)cm^(3)、(137.85±10.56)mm,差异有统计学意义(P<0.05)。头颅CT诊断灵敏度为86.67%(39/45)、特异度为91.11%(41/45)和准确率为88.89%(80/90)。结论:头颅CT检查可为老年性痴呆早期诊断提供较多的诊断资料,患者具有双侧海马体积缩小、外侧脑裂宽度减小,三脑室宽度、尾状核指数、额角指数、侧脑室宽度、平均脑沟宽度增加等表现,有助于提升患者诊断准确率,降低漏诊、误诊风险,临床诊断价值较高。

Objective:To explore the clinical application value of CT in the early diagnosis of senile dementia.Methods:45 cases of early senile dementia patients admitted to our hospital from March 2020 to March 2021 were selected as dementia group,and 45 healthy people who underwent physical examination in our hospital during the same period were selected as the same age healthy group.Subjects in both groups underwent head CT examination,and the relevant measurement indexes,bilateral hippocampal volume and left and right brain diameter of the two groups were compared.Results:The lateral brain split width of dementia group(0.72±0.23)mm was significantly lower than that of healthy group(1.28±0.29)mm.Third ventricle width(7.29±2.13)mm,caudate nucleus index(18.56±3.02)%,frontal Angle index(18.56±3.02)%,lateral ventricle width(4.56±0.75)mm,mean sulci width(17.05±3.02)mm,frontal sulci width(2.86±1.25)mm were significantCompared with healthy group of the same age[(4.46±1.79)mm,(11.98±2.56)%,(30.57±4.58)%,(3.05±1.11)mm,(4.61±1.75)mm,(1.58±0.45)mm],the difference was statistically significant(P<0.05).The right hippocampal volume(2.16±0.56)cm^(3),left hippocampal volume(2.14±0.39cm^(3))and left and right cerebral diameter(130.25±8.57)mm in dementia group were significantly lower than those in healthy group of the same age(2.62±0.48)cm^(3),(2.53±0.45)cm^(3),(137.85±10.56)mm.The difference was statistically significant(P<0.05).The diagnostic sensitivity,specificity and accuracy of head CT were 86.67%(39/45),91.11%(41/45)and 88.89%(80/90).Conclusion:Skull CT examination for early diagnosis of dementia to provide more diagnostic information,hippocampal volume was lower bilaterally in patients with narrow,lateral brain LieKuan degree decreases,and the third ventricle width,caudate nucleus index,the index of the frontal and lateral ventricle width,such as average groove width increase performance,help to improve the diagnosis accuracy and reduce the risk of missed diagnosis and misdiagnosis,clinical diagnostic value is higher.