脑囊虫病ELISA试验、CT及MRI对比研究

目的:研究ELISA囊虫试验、脑CT及MRI对脑囊虫病的诊断价值。方法:采用回顾性研究,主要对比分析临床确诊的42例脑囊虫病患者的血清及脑脊液ELISA囊虫试验、脑CT及MRI结果。结果:ELISA脑囊虫试验血清抗原、抗体检测阳性率均为54%,脑脊液抗原阳性率为60%,抗体阳性率为15%,抗体假阴性率为85%;血清及脑脊液囊虫抗原阳性一致者46%,抗体阳性一致者35%。42例脑CT/MR检查中,40%患者病灶呈局灶性分布,60%患者病灶呈弥漫性分布;大部分(93%)患者脑CT/MR显示活的囊尾蚴病灶与死的囊尾蚴病灶并存。脑CT及MR两者均进行扫描的患者11例,其中2例CT表现为弥漫性脑水肿,其余病例CT及MR病灶部位基本一致,但MR显示的病灶数目明显多于CT。结论:目前对脑囊虫病的诊断必须依赖综合性措施。

Contrastive study about ELISA,CT and MRI of brain in patients with Cerebral cysticercosis

Objective:To study the clinical diagnostic significence of ELISA, brain CT and MRI in patients with cerebral cysticercosis.Methods:With the method of retrospective control study, to analyse the results of CSF and serum ELISA cysticercus’s test, brain CT and MRI in 42 patients who have been diagnosed as cerebral cysticercosis. Results: In ELISA cysticercus test, the positive rate of both antigen and antibody is 54% in serum, the positive rate of antigen is 60% in CSF and the positive rate of antibody is 15%, the false negative rate is 85%. The antigen of CSF and serum in 46% patients is positive, but only 35% antibody is positive. The brain CT and/or MRI in 40% patients show local lesion, 60% of them show universal lesion. In 93% patients, the brain CT and/or MRI show that the dead and live cysticercuses coexist. In 11 patients who carry out brain CT and MRI, except 2 patients whose brain CT and MRI show universal hydrocephalus, the brain CT and MRI in others show the same lesion positions, but lesions in MRI are more than those in CT obviously. 6 patients (14%) whose brain CT or MRI show typical live cysticercus, but their antigen and antibody in CSF are negative, the onset of 3 patients in these 6 patients is acute and serious. The positive rate of both antigen and antibody in serum or CSF are higher in patients whose lesions in MRI are more than 3 than those whose lesions in MRI is less than 3. Conclusion: At present, the diagnosis of cerebral cysticercosis should depend on a integrate method.