影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (6): 1502-1506.DOI: 10.7517/issn.1674-0475.220709

• 综述与论文 • 上一篇    下一篇

CT和MRI在颅脑手术后患者颅内感染诊断中的价值及危险因素分析

贾哲勇, 李旭朝, 唐艳丽, 陈烈, 肖为, 梅涛   

  1. 常德市第一人民医院神经外科, 湖南 常德 415000
  • 收稿日期:2022-07-12 出版日期:2022-11-23 发布日期:2022-11-15
  • 通讯作者: 梅涛
  • 基金资助:
    湖南省卫计委项目(D202304047957)

Analysis of the Value of CT and MRI in Diagnosis of Intracranial Infection in Patients

JIA Zheyong, LI Xuzhao, TANG Yanli, CHEN Lie, XIAO Wei, MEI Tao   

  1. Department of Neurosurgery, The First People's Hospital of Changde City, Changde 415000, Hunan, P. R. China
  • Received:2022-07-12 Online:2022-11-23 Published:2022-11-15

摘要: 本研究观察CT和MRI在颅脑手术后患者颅内感染诊断中的价值,并分析影响患者发生颅内感染的危险因素。以颅脑手术后疑似发生颅内感染患者为研究对象。所有患者均接受MRI和CT检查。经脑脊液培养,300例疑似颅内感染患者最终确诊54例,感染病原菌主要为革兰阳性菌,占比为61.11%,革兰阴性菌感染患者占比为38.89%。最终CT诊断颅脑手术后患者并发颅内感染的灵敏度为77.78%、特异度为79.67%、准确度为79.33%;MRI诊断颅脑手术后患者并发颅内感染的灵敏度为83.33%、特异度为87.80%、准确度为87.00%。手术方式为开放式手术、手术次数超过1次、手术时间超过6h、脑室外引流时间超过5d会增大患者术后并发颅内感染的风险(OR值分别为1.806、2.160、1.626、1.694,P<0.05)。MRI对颅脑手术后患者颅内感染诊断准确率高于CT检查,引起颅脑手术后并发颅内感染的因素有多种,对此应予以重视并及时进行针对性干预,以降低发生颅内感染的风险。

关键词: 计算机断层扫描, 磁共振成像, 颅脑手术, 颅内感染

Abstract: This study observed the value of CT and MRI in the diagnosis of intracranial infection in patients after craniocerebral surgery, and analyzed the risk factors affecting the occurrence of intracranial infection in patients. Patients with suspected intracranial infection after craniocerebral surgery were selected as the research objects. All patients underwent MRI and CT examinations. After cerebrospinal fluid culture, 54 of 300 patients with suspected intracranial infection were finally diagnosed. The main infectious pathogens were Gram-positive bacteria, accounting for 61.11%, and Gram-negative bacteria accounted for 38.89% of patients. The sensitivity of CT in the diagnosis of intracranial infection in patients with craniocerebral surgery was 77.78%, the specificity was 79.67%, and the accuracy was 79.33%. The sensitivity of MRI in diagnosing intracranial infection in patients with craniocerebral surgery was 83.33%, the specificity was 87.80%, and the accuracy was 87.00%. Open surgery, more than one operation, more than 6 hours of operation time, and more than 5 days of extraventricular drainage will increase the risk of postoperative intracranial infection (OR values were 1.806, 2.160, 1.626, 1.694, respectively, P<0.05). The accuracy of MRI in diagnosing intracranial infection in patients after craniocerebral surgery is higher than that of CT examination. There are many factors that cause intracranial infection after craniocerebral surgery, which should be paid attention to and timely targeted intervention to reduce the risk of intracranial infection.

Key words: CT, MRI, brain surgery, intracranial infection