MRI与CT对小儿病毒性脑炎的诊断效能对比

Comparison on the Diagnostic Efficacy between MRI and CT in Children with Viral Encephalitis

目的比较MRI与CT对小儿病毒性脑炎的诊断效能。方法选择2021年6月至2023年3月我院收治的疑似病毒性脑炎患儿81例,均行MRI、CT检查,以脑脊液病原学检查作为金标准,对比MRI与CT的诊断灵敏度、特异度、准确率。结果经脑脊液病原学检查确诊为病毒性脑炎患儿59例,非病毒性脑炎患儿22例;MRI与脑脊液病原学诊断结果一致性较好(κ=0.908,P=0.000),CT与脑脊液病原学诊断结果一致性一般(κ=0.447,P=0.000)。MRI诊断小儿病毒性脑炎的灵敏度、特异度、准确率分别为96.61%、95.45%、96.30%,显著高于CT的79.66%、68.18%、76.54%(P<0.05)。结论MRI较CT诊断小儿病毒性脑炎具有更高的灵敏度、特异度及准确率,可降低漏诊、误诊风险,临床诊断时可优先考虑。

Objective To compare the diagnostic efficacy of MRI and CT in children with viral encephalitis.Methods 81 cases of children with suspected viral encephalitis admitted to our hospital from June 2021 to March 2023 were selected and given MRI and CT.Taking cerebrospinal fluid pathology as the gold standard,the diagnostic sensitivity,specificity and accuracy of MRI and CT were compared.Results 59 children with viral encephalitis and 22 children with non viral encephalitis were diagnosed by cerebrospinal fluid pathology.MRI had better consistency with cerebrospinal fluid pathology(κ=0.908,P=0.000),and CT had normal consistency with cerebrospinal fluid pathology(κ=0.447,P=0.000).The sensitivity,specificity and accuracy of MRI in the diagnosis of viral encephalitis were 96.61%,95.45%and 96.30%,respectively,significantly higher than 79.66%,68.18%and 76.54%of CT(P<0.05).Conclusions Compared with CT,MRI has higher sensitivity,specificity and accuracy in the diagnosis of children with viral encephalitis,and can reduce the risk of missed diagnosis and misdiagnosis,which should be given priority in clinical diagnosis.