磁共振成像与CT对脑出血的鉴别对比分析

目的 探讨CT和磁共振(MRI)检查诊断脑出血的临床价值.方法 对本院2010年3月至2014年3月手术后病理确诊的101例脑出血患者的术前CT、MRI检查资料进行回顾性分析,比较CT和MRI检查判定结果与手术后病理检查结果的一致性,并计算两种影像学检查的诊断学评价指标.结果 CT与MRI对基底节出血、脑叶出血的诊断结果与病理检查结果的符合率比较差异无统计学意义(P＞0.05),CT检查壳核出血、丘脑出血与术后病理检查结果的符合率分别为59.09％、47.37％,显著低于MRI检查与术后病理检查结果的符合率(86.36％、94.74％) (P＜0.05).MRI检查术前诊断脑出血的灵敏度为94.74％、特异度为96.04％与CT检查术前诊断的灵敏度(47.37％)、特异度(85.37％)比较差异具有统计学意义(P＜0.05);MRI检查术前脑出血的误诊率为3.66％、漏诊率为5.26％,Kappa=0.875,均低于CT检查的14.85％、52.47％、Kappa=0.315.结论 MRI的诊断学评价指标诊断脑出血优于CT,可作为脑出血的一种有效检查方法,为临床治疗提供可靠的影像学依据.

Comparison of magnetic resonance imaging and CT in the identification of cerebral hemorrhage

Objective To investigate the clinical value of CT and magnetic resonance imaging (MRI) in the diagnosis of cerebral hemorrhage.Methods Preoperative CT and MRI data of 101 patients with cerebral hemorrhage from March 2010 to March 2014 were analyzed retrospectively,and the results were compared with postoperative pathological results,and calculated the diagnostic value of two imaging examinations.Results There were no statistically significant differences in the coincidence rates of the diagnosis of basal ganglia hemorrhage,lobar intracerebral hemorrhage by CT,MRI and postoperative pathological results (P＞0.05).The coincidence rates of the diagnosis of putamen hemorrhage,thalamic hemorrhage by CT and postoperative pathological results were 59.09％,47.37％,significantly lower than those by MRI (P＜0.05).The sensitivity,specificity of MRI in the diagnosis of cerebral hemorrhage were 94.74％,96.04％,higher than 47.37％,85.37％ of CT (P＜0.05).The misdiagnosis rate,the rate of missed diagnosis,Kappa value of MRI in the diagnosis of cerebral hemorrhage were 3.66％,5.26％,0.875,all lower than 14.85％,52.47％,0.315 of CT.Conclusion The diagnostic value of MRI is better than CT,which can be used as an effective method for the diagnosis of cerebral hemorrhage.