摘要
目的探讨免疫学检查和影像学检查在脑囊虫病诊断中的应用价值及临床意义。方法回顾我院2012年12月—2017年12月收治的94例脑囊虫病患者临床资料,统计其免疫学检查及影像学检查诊断结果,并进行分析比较。结果 94例脑囊虫病患者血清学IHA、ELISA及IgG4检查结果阳性率均高于脑脊液(87.23%vs. 69.15%,90.43%vs.64.89%,84.04%vs. 62.77%),ELISA及IgG4假阴性率均低于脑脊液(9.73%vs. 35.11%,15.96%vs. 37.23%),差异均具有统计学意义(P均<0.05)。94例患者脑MRI显示单发病灶33例(35.11%),多发61例(64.89%),病灶囊内长T_1、T_2信号,部分病灶囊内可见头节,周边伴有水肿,具有占位效应。结论脑囊虫病患者血清学免疫检查阳性率较脑脊液高,但也存在假阴性结果 ;MRI检查可以显示脑囊虫病不同病期的影像学征象,具有一定的特异性,血清免疫学检查结合MRI影像学手段可以更准确地诊断脑囊虫病。
Objective To explore the value and clinical significance of immunological examination and imaging examination in the diagnosis of cerebral cysticercosis. Methods 94 cases of cerebral cysticercosis in our hospital from December 2012 to December 2017 were reviewed. The results of immunological examination and imaging examination were statistically analyzed. The analysis and comparison were carried out. Results The positive rates of serological IHA, ELISA and IgG4 in 94 patients with cerebral cysticercosis were higher than those of cerebrospinal fuid （87.23% vs. 69.15%, 90.43% vs. 64.89%, 84.04% vs. 62.77%）. The false negative rates of ELISA and IgG4 were lower than those of CSF （9.73% vs. 35.11%, 15.96% vs. 37.23%）. The difference was statistically signifcant （P 〈 0.05）. In 94 patients, MRI showed 33 lesions （35.11%）. 61 lesions （64.89%） were multiple. Long T1 and T2 signals in the foci of the lesion, a part of the foci was seen in the capsule. MRI of 94 patients showed single lesion in 33 cases （35.11%） and multiple lesions in 61 cases （64.89%）. There were long T1 and T2 signals in the lesions, some lesions showed head ganglion in the lesions and edema around the lesions. Conclusion The positive rate of serological immunity test in patients with cerebral cysticercosis is higher than that in cerebrospinal fluid, but there are also false negative results. MRI examination can show the imaging signs of different stages of cerebral cysticercosis, with a certain degree of specificity, serum immunology combined with MRI imaging means can more accurately diagnose cerebral cysticercosis.
作者
冯文
郑宏伟
陈昌平
张桓
王嗣嵩
任骥
FENG Wen;ZHENG Hongwei;CHEN Changping;ZHANG Huan;WANG Sisong;REN Ji(Department of Neurosurgery,No.363 Hospital,Chengdu Sichuan 610041,China)
出处
《中国继续医学教育》
2018年第33期77-79,共3页
China Continuing Medical Education
基金
四川省科技计划项目(脑包虫
囊虫病微创外科规范化治疗的临床研究)(2012FZ0040)
关键词
脑囊虫病
免疫学
影像学
血清
诊断
分析
cerebral cysticercosis
immunology
imaging
serum
diagnosis
analysis
