MRI结合256排CT在脑胶质瘤患者术前诊断中的应用价值

Application Value of MRI Combined with 256 Row CT in Preoperative Diagnosis of Glioma

目的:分析磁共振成像(MRI)结合256排CT在脑胶质瘤患者术前诊断中的应用价值。方法:选取2018年6月-2021年6月佳木斯市中心医院收治的疑似脑胶质瘤患者91例,术前均行MRI、256排CT诊断。以术后病理结果为诊断“金标准”,统计MRI、256排CT单独诊断与两者联合诊断疑似脑胶质瘤患者的诊断结果与诊断效能,并记录不同级别脑胶质瘤检出情况。结果:91例疑似脑胶质瘤患者,术后病理确诊阳性82例,阴性9例;MRI诊断真阳性76例,真阴性5例;256排CT诊断真阳性78例,真阴性6例;MRI结合256排CT诊断真阳性81例,真阴性9例。MRI结合256排CT诊断与病理结果一致性较好(Kappa=0.941),较MRI(Kappa=0.439)、256排CT(Kappa=0.589)诊断更准确。三种方式诊断准确度比较,差异有统计学意义(P<0.05),MRI结合256排CT诊断准确度最高(P<0.05)。MRI结合256排CT、MRI、256排CT病理分级与术后病理分级一致性Kappa值分别为0.982、0.891、0.928。结论:MRI结合256排CT对脑胶质瘤患者进行术前诊断,准确度更高,可为临床提供全面且科学的病灶信息,辅助临床优化手术方案,临床应用价值较高。

Objective:To analyze the application value of magnetic resonance imaging(MRI)combined with 256 row CT in preoperative diagnosis of patients with glioma.Method:A total of 91 patients with suspected glioma in Jiamusi Central Hospital from June 2018 to June 2021 were selected,and MRI and 256-slice CT were performed before operation.The“gold standard”for diagnosis was the postoperative pathological results,the diagnosis results and efficacy of patients diagnosed with MRI and 256-slice CT with suspected glioma were counted,and the detection of glioma of different levels was recorded.Result:Among 91 patients with suspected glioma,82 were positive and 9 were negative by postoperative pathology.MRI diagnosis was true positive in 76 cases and true negative in 5 cases.256-slice CT was true positive in 78 cases and true negative in 6 cases.MRI combined with 256-slice CT was true positive in 81 cases and true negative in 9 cases.MRI combined with 256-slice CT showed good consistency with pathological results(Kappa=0.941),which was more accurate than MRI(Kappa=0.439)and 256-slice CT(Kappa=0.589).There was statistically significant difference in diagnostic accuracy among the three methods(P<0.05),MRI combined with 256-slice CT had the highest diagnostic accuracy(P<0.05).The concordency Kappa values of MRI combined with 256-slice CT,MRI,256-slice CT and postoperative pathological grading were 0.982,0.891 and 0.928,respectively.Conclusion:MRI combined with 256-slice CT CT in preoperative diagnosis of gliomas has higher accuracy,which can provide comprehensive and scientific clinical lesion information,assist in clinical optimization of surgical plan,and has high clinical application value.