磁共振成像及脑脊液细胞学对病毒性脑(膜)炎的诊断性研究

摘要

目的 探讨MRI和脑脊液细胞学检测阳性率、异常程度和发病时间对病毒性脑(膜)炎诊断和制定治疗方案的指导价值.方法 回顾189例病毒性脑(膜)炎患者的头部MRI及脑脊液检查资料,分析MRI正常或异常患者在疾病早期的脑脊液细胞学改变.结果 189例患者中96例(50.79％)呈现MRI异常影像、129例(68.25％)脑脊液细胞学检测异常.MRI异常患者中脑脊液细胞学检测异常率为72.92％( 70/96),与MRI正常患者(63.44％,59/93)比较差异具有统计学意义(P=0.000).结论 病毒性脑(膜)炎患者在疾病早期MRI改变晚于脑脊液细胞学改变,但二者对提示诊断和制定治疗方案均具有重要临床意义.%Objective To explore the significance of magnetic resonance imaging (MRI) and cerebrospinal fluid cytology in the diagnosis and treatment of viral encephalitis (meningitis). Methods The head MRI and cerebrospinal fluid data of 189 patients with viral encephalitis (meningitis) were reviewed, and early changes of cerebrospinal fluid cyotology of patients with normal or abnormal MRI findings were analysed retrospectively. Results Among 189 viral encephalitis (meningitis) patients, 96 (50.79%) patients presented abnormal MRI, and 129 (68.25%) patients presented abnormal cerebrospinal fluid cytological findings. In patients with abnormal MRI the abnormality rate of cerebrospinal fluid cytological findings was 72.92% (70/96), while in patients with normal MRI it was 63.44% (59/93), the difference was significant (P = 0.000). Conclusion In the early stage of viral encephalitis (meningitis) MRI changes appear later than abnormal cerebrospinal fluid cytological findings, but both of them are important for clinical diagnosis and treatment of this disease.