摘要
目的探究MRI应用于中枢神经系统白血病侵犯的诊断价值,分析患者侵犯后的临床症状表现。方法将2017年9月-2019年6月作为研究时段,在该时段对我院数据库进行调查,确认其中资料登记有效的白血病患者194例作为研究对象。所有患者在入院后进行头颅、全脊柱的MRI增强扫描以及患者的脑脊液细胞学检查,根据患者检查结果中是否存在中枢神经系统症状将其分为症状表现组以及无症状表现组。结果MRI与CSF细胞学检查真阳性检出上并没有显著差异,P>0.05;MRI检查中症状表现组总计20例(80.00%),无症状表现组总计20例(80.00%),其中症状表现组检出患者最多,混合型中枢神经系统白血病占比最高;MRI检查中敏感度88.23%,特异度94.35%,准确性93.81%,误诊率5.64%,漏诊率11.76%,阳性预测值60.00%,阴性预测值98.81%,假阳性率5.64%,假阴性率11.76%,正确指数82.58%。结论MRI对于白血病中枢神经系统侵犯,具有良好的诊断敏感性,能够检测出CSF细胞学检测为阴性的白血病中枢神经系统侵犯患者;将这种影像学检查方式与CSF细胞学检查联合应用于临床诊断中能够降低白血病中枢神经系统侵犯的检测假阴性率具有较高的可用价值。
Objective To explore diagnostic value of MRI in central nervous system leukemia invasion and analyze clinical symptoms of patients after invasion.Methods With research period of September 2017 to June 2019,the paper investigated database of our hospital,and confirmed 194 cases leukemia patients with valid data registration as research objects.After admission,all cases were treated with enhanced MRI scanning of head and whole spine and cytological examination of cerebrospinal fluid.According to whether there were central nervous system symptoms in examination results,patients were divided into symptom group and asymptomatic group.Results There was no significant difference between MRI and CSF cytology(P>0.05);in MRI examination,there were 20 cases(80.00%)in symptomatic group and 20 cases(80.00%)in asymptomatic group.Patients in symptomatic group were the most,proportion of mixed central nervous system leukemia was the highest.in MRI examination,sensitivity was 88.23%,specificity was 94.35%,accuracy was 93.81%,misdiagnosis rate was 5.64%,missed diagnosis rate was 11.76%,positive predictive value was 60.00%,negative predictive value was 98.81%,false positive rate was 5.64%,false negative rate was 11.76%,and accuracy index was 82.58%.Conclusion MRI can achieve good diagnostic sensitivity for central nervous system invasion of leukemia,and detect patients with central nervous system invasion of leukemia with negative CSF cytology;Combination of imaging examination and CSF cytology can reduce false negative rate of leukemia central nervous system invasion in clinical diagnosis,which has high availability value.
作者
徐娟
XU Juan(Magnetic Resonance Department,Qujing City The First People's Hospital,Qujing Yunnan,655000)
出处
《智慧健康》
2022年第6期7-9,共3页
Smart Healthcare
