CT在偏执型首发精神分裂症患者中的应用及影像特点分析

Application of CT in patients with paranoid first-episode schizophrenia and the imaging features

目的:分析CT在偏执型首发精神分裂症(FES)患者中的应用价值及影像特点。方法:抽取90例偏执型FES患者为研究组,另选80例健康者为对照组。均接受头部CT扫描,并测量双侧额叶等脑叶CT均值,分析研究组患者CT影像特点,并随访1年统计复发情况,评价生活质量。结果:研究组脑室扩大、脑沟增宽、大枕大池、蛛网膜囊肿发生率明显高于对照组(P<0. 05);研究组双侧额叶CT均值显著低于对照组(P<0. 05)。90例患者中,1年复发率为31. 11%,复发者脑室扩大、脑沟增宽、大枕大池、蛛网膜囊肿发生率明显高于未复发者(P<0. 05);与未复发者相比,复发者双侧颞叶CT均值较低(P<0. 05),精神分裂症患者生活质量量表(SQLS)各维度评分较高(P<0. 05);而双侧颞叶CT均值与SQLS各维度评分呈负相关(P<0. 05)。结论:偏执型FES患者的影像特点主要变现为脑室扩大、脑沟增宽、大枕大池、蛛网膜囊肿及额叶CT值下降,CT在其早期诊断及预后评估方面有重要应用价值。

Objective:To analyze the application value of CT in patients with paranoid first-episodeschizophrenia(FES)and the imaging features.Methods:A total of 90 patients with paranoid type FES and80 healthy subjects were involved in this study.All patients underwent head CT scan,and the mean CT value of bilateral frontal lobes and other cerebral lobes were measured.The CT imaging characteristics of the patients were analyzed.The recurrence of the patients was followed up for one year to evaluate the quality of life.Results:The incidence rates of enlarged ventricles,widened sulc,largecisterna magna and arachnoid cyst in paranoid FES group were significantly higher than those in control group(P<0.05).The mean CT values of bilateral frontal lobes in the study group were significantly lower than those in control group(P<0.05).The 1-year recurrence rate of 90 patients was 31.11%.The incidence rates of enlarged ventricles,widened sulc,large cisterna magna and arachnoid cyst in patients with recurrence were significantly higher than those in the control group(P<0.05).Compared with patients without recurrence,the mean CT values of bilateral temporal lobes in patients with recurrence were significantly lower,and the score of each dimension of the quality of life scale(SQLS)was significantly higher in schizophrenics(P<0.05);the mean CT value of bilateral temporal lobe was negatively correlated with the score of each dimension of SQLS(P<0.05).Conclusion:The imaging features of patients with paranoid FES mainly include enlarged ventricles,widened sulci,large cisterna magna,arachnoid cyst,and decreased CT values of frontal lobe.CT is of great value in the early diagnosis and evaluation of prognosis for patients with paranoid FES.