摘要
目的探讨脑脊液生化检测联合磁共振成像(MRI)在小儿脑膜炎中的诊断价值。方法选取2017年6月至2019年12月于我院收治的疑似脑膜炎患儿86例作为研究对象,对入组患儿均行脑脊液生化检测、病原学检测和MRI检查,以病原学检查结果为"金标准",观察患儿脑脊液糖、蛋白、氯化物和腺苷脱氨酶(ADA)水平以及MRI影像表现,比较脑脊液生化检测联合MRI以及单纯脑脊液生化检测的诊断结果,以及两种诊断方法的敏感度、特异度、准确率、阳性预测值、阴性预测值和k.appa.值。结果8l6例患者的脑脊液葡萄糖.水平为(.175±036)mmo/L,脑脊液蛋白.水平为(1.79±052l)g/L,脑脊液氯化物水平.为(107.38±1197)mmo/L,脑脊液ADA水平为(972±235)U/L,均超出其正常值范围;患儿MRI图像大多呈长T1信号,未累计内囊,边界清晰,可出现脑回样强化;经脑脊液病原学诊断,小儿脑膜炎确诊患者74例,非脑膜炎患者12例;脑脊液生化检测联合MRI诊断小儿.脑膜炎的灵敏度明显高于单独脑脊液生化检测(P<005),且脑脊液.生化检测联合MRI诊断与病理诊断的Kappa值为0849,.大于单独脑脊液生化检测与病理诊断的Kappa值(0680)。结论相比单独脑脊液生化检测,脑脊液生化检测联合MRI诊断小儿脑膜炎的灵敏度较高,与病原学诊断结果具有较高的一致性,具有较高的有效性和临床应用价值。
Objective To explore the diagnostic value of the biochemical test in cerebrospinal fluid(CSF)combined with magnetic resonance imaging(MRI)in pediatric meningitis.Methods A total of 86 children with suspected meningitis who were admitted to the hospital from June 2017 to December 2019 were enrolled as the research objects.All underwent CSF biochemical test,pathogens test,and MRI examination.Ta king pathogenic examination results as the golden standard,glucose levels,protein,chloride,and adenosine deaminase(ADA)in CSF and MRI findings were observed.The diagnostic results of the CSF biochemical test combined with MRI and simple CSF biochemical test,and the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and kappa value of the two diagnostic methods were compared.Results The levels of glucose,protein,chloride and ADA in CSF of the 86 patients were(1.75±0.36)mmol/L,(1.79±0.52)g/L,(107.38±11.97)mmol/L,and(9.72±2.35)U/L,which are beyond their normal ranges.MRI images of children mostly showed long T1 signals,not involved in the internal capsule.The boundaries were clear.Moreover,there was cerebral gyrus-like enhancement.CSF etiology diagnosis showed there were 74 cases with pediatric meningitis and 12 cases without meningitis.The sensitivity of the CSF biochemical test combined with MRI was significantly higher than that of the simple CSF biochemical test for diagnosis of pediatric meningitis(P<0.05).Kappa value between the CSF biochemical test combined with MRI and pathological diagnosis was greater than between simple CSF biochemical test and pathological diagnosis(0.849 vs.0.680).Conclusion Compa red with the simple CSF biochemical test,the sensitivity of the CSF biochemical test combined with MRI is higher for pediatric meningitis diagnosis,with higher consistency with pathogenic diagnosis results,higher effectiveness,and clinical application value.
作者
吕亚洲
耿巧玲
杨红
LYU Ya-zhou;GENG Qiao-ling;YANG Hong(PICU,the Central Hospital of Nanyang City,Nanyang 473000,Henan Province,China;Blood Purification Center,the Central Hospital of Nanyang City,Nanyang 473000,Henan Province,China)
出处
《中国CT和MRI杂志》
2021年第5期131-133,共3页
Chinese Journal of CT and MRI
关键词
脑脊液
生化检测
磁共振成像
小儿脑膜炎断
灵敏度
Cerebrospinal Fluid
Biochemical Test
Magnetic Resonance Imaging
Pediatric Meningitis
Sensitivity
