摘要
目的研究分析脑脓肿患者的感染机制及影像学检查临床意义,探讨弥散加权成像与磁共振波普分析等影像学方法在脑脓肿的临床诊断效果,为临床医师的早期诊断治疗提供一定参考。方法选取医院2012年11月-2016年9月神经外科收治的70例脑脓肿患者,所有患者入院后均行头部CT及MRI平扫联合增强检查,其中44例患者行弥散加权成像检查,5例行磁共振波普分析检查。结果所有患者行常规影像学检查后均显示脑脓肿为包膜期;CT显示脑脓肿边界清晰或为不清晰的类圆形的低密度影,CT增强后可显示边缘区强化,3例患者增强后边缘区强化不明显;MRI显示,T1WI为低信号类圆形病灶,T2WI为高信号,且脓肿边缘可见长T2信号水肿;随访期间对所有患者进行格拉斯哥愈后评分(GOS)评估,70例患者的GOS评分中,5分56例,4分4例,3分4例,1分6例。结论对于脑脓肿患者入院后行常规CT、MRI结合DWI、MRS等检查,可有效提高对脑脓肿诊断准确率,对于脓肿和脑肿瘤的鉴别意义重大。
OBJECTIVE To investigate infection mechanism and imaging examination clinical significance in patients with brain abscess, discuss clinical diagnostic effects of diffusion weighted imaging and magnetic resonance （NMR） spectral analysis of brain abscess, so as to provide references for early diagnosis and treatment of clinical physicians. METHODS A total of 70 cases of patients with brain abscess in neurosurgery from Nov. 2012 to Sep. 2016 were selected. All patients were carried out head CT and MRI scan in combination with enhanced examina- tion after admission, including 44 cases of patients with diffuse weighted imaging, and 5 cases with magnetic reso- nance （NMR） spectral analysis. RESULTS All patients showed brain abscesses were in the capsule stage by routine imaging examination. CT showed that brain abscesses had clear boundaries or not clear of circular low density shadow, CT could show enhancement of fringe area, and 3 cases of patients were not obvious with fringe area en- hancement. MRI showed that T1WI was low signal of circular lesions, T2WI was high signal, and long T2 signal edema could be seen on abscess margin. All patients were followed up with Glasgow prognostic score （GOS） eval- uation during the follow-up period to assess the GOS score in 70 patients, 56 cases had 5 points, 4 cases had 4 points, 4 cases had 3 points, and 6 cases had 1 point. CONCLUSION Conventional CT and MRI combined with DWI and MRS examinations in patients with brain abscess after admission can effectively improve the diagnostic accuracy of brain abscess, which is of great significance for the identification of abscess and brain tumors.
作者
周明华
林兴旺
胡振平
周剑青
余小君
ZHOU Ming-hua LIN Xing-wang HU Zhen-ping ZHOU Jian-qing YU Xiao-jun(Qingyuan Peoplets Hospital ,Lishui, Zhejiang 323800, Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第7期1550-1553,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技计划项目(2014KYB361)
关键词
脑脓肿
感染机制
影像学检查
临床意义
Brain abscess
Infection mechanism
Imaging examination
Clinical significance
