目的 研究磁共振成像（MRI）、经直肠超声（TRUS）结合血清前列腺特异性抗原（PSA）诊断前列腺癌诊断的应用价值。方法 收集2020年1月—2023年1月前在武穴市第一人民医院检查的疑似前列腺癌患者140例,均给予MRI、TRUS检查,并进行血清PSA水平检测,以患者手术病理结果为金标准,观察单一MRI、TRUS、血清PSA及联合诊断时漏诊、误诊情况,进行一致性分析,计算各项单一诊断及联合诊断的诊断灵敏度、特异度、准确率。结果 经手术病理结果证实为前列腺癌81例,非前列腺癌59例,前列腺癌患者血清PSA水平高于非前列腺癌患者（P<0.05）;单一MRI、TRUS或PSA诊断前列腺癌与手术病理结果的一致性一般（Kappa=0.641、0.624、0.536,均P<0.001）,联合诊断与手术病理结果的一致性较好（Kappa=0.906,P<0.001）;联合诊断的灵敏度、特异度、准确率为高于单一MRI、TRUS、血清PSA及各诊断方式两两联合（P<α,α=0.007）。结论 前列腺癌诊断中单一MRI、TRUS、血清PSA诊断均存在漏诊、误诊风险,联合诊断可弥补单一诊断的不足,提高前列腺癌患者的诊断准确率。

Objective To study the application value of magnetic resonance imaging（MRI）,transrectal ultrasound（TRUS）combined with serum prostate-specific antigen（PSA）in the diagnosis of prostate cancer．Methods A total of 140 patients with suspected prostate cancer who were examined at Wuxue First People's Hospital from January 2020 to January 2023 were enrolled．MRI and TRUS examinations were performed,and serum PSA levels were tested．The surgical pathology results of the patients were used as the gold standard．The missed diagnosis and misdiagnosis in single MRI,TRUS,serum PSA and combined diagnosis were observed,consistency was analyzed,and the diagnostic sensitivity,specificity,and accuracy of each single diagnosis and combined diagnosis were calculated．Results There were 81 cases of prostate cancer and 59 cases of non-prostate cancer confirmed by surgical pathology results．The serum PSA level of prostate cancer patients was higher than that of non-prostate cancer patients（P<0.05）．The difference between the diagnosis of prostate cancer by single MRI,TRUS or PSA and the results of surgical pathology was with general consistency（Kappa=0.641,0.624,0.536,all P<0.001）,and the consistency of combined diagnosis and surgical pathology results was good（Kappa=0.906,P<0.001）．The sensitivity,specificity,and accuracy of combined diagnosis were higher than single MRI,TRUS,serum PSA and the combination of two diagnostic methods（P<α,α=0.007）．Conclusions In the diagnosis of prostate cancer,single MRI,TRUS and serum PSA diagnosis all have risks of missed diagnosis and misdiagnosis．Combined diagnosis can make up for the shortcomings of single diagnosis and improve the diagnostic accuracy of prostate cancer．

目的 探讨血清脂联素（ADPN）、糖类抗原125（CA125）及抗苗勒管激素（AMH）水平检测在多囊卵巢综合征（PCOS）中的临床诊断价值。方法 选取2022年1月—2022年9月在东莞市中医院经鹿特丹诊断标准确诊的100例PCOS患者作为PCOS组;PCOS组通过测定患者体质量指数（BMI）是否大于28 kg/m²分为肥胖组和非肥胖组;测定患者的睾酮水平的高低是否大于80 ng/dL分为高雄激素组和非高雄激素组。另选身体健康、年龄与PCOS组相近的100名健康女性作为对照组。分别测定PCOS组和对照组的ADPN、CA125以及AMH,分析血清ADPN、CA125、AMH在PCOS患者中的检测价值。结果 POCS组的BMI、AMH、CA125、睾酮、ADPN与健康组比较差异均有统计学意义（P<0.05）。与对照组比较,PCOS组的BMI、AMH、CA125、睾酮水平升高、ADPN水平降低。PCOS患者的CA125与AMH水平呈正相关（P<0.05）,ADPN与AMH无关（P>0.05）。结论 PCOS 患者血清CA125和AMH水平升高,ADPN水平降低。

Objective To explore the clinical diagnostic value of serum adiponectin（ADPN）,carbohydrate antigen 125（CA125）and anti-Mullerian hormone（AMH）levels in polycystic ovary syndrome（PCOS）．Method A total of 100 patients confirmed with PCOS in Dongguan Traditional Chinese Medicine Hospital from January 2022 to September 2022 were selected as the study subjects．All patients were diagnosed with PCOS according to the 2003 Rotterdam diagnostic criteria,and served as the PCOS group．The PCOS group was divided into obese and non obese group by measuring the patient’s body mass index（BMI）whether was greater than 28 kg/m²．A high androgen group and a non high androgen group were determined by whether the patient’s testosterone level is greater than 80 ng/dL．A hundred healthy women of similar age were selected as the healthy control group．The levels of ADPN,CA125 and AMH were measured in the experimental and control group,and their detection value were analyzed．Results BMI,AMH,CA125,testosterone and ADPN in the POCS group were statistically different compared to the healthy group（P<0.05）．Compared with the PCOS group,the control group showed a significant increase in BMI,AMH,CA125 and testosterone levels,while the PCOS group showed a decrease in ADPN level．There was a positive correlation between CA125 and AMH in patients with PCOS,while there was no correlation between ADPN and AMH．Conclusions The levels of serum CA125 and AMH in PCOS patients significantly increased,while the level of ADPN decreased．The three indicators have good diagnostic value in PCOS and are worth promoting．

目的 评估全身免疫炎症指数（SII）、中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）在区分急性缺血性卒中（AIS）伴发卵圆孔未闭（PFO）与非伴发PFO患者的价值。方法 回顾性分析100例AIS患者的血液和血清指标,计算SII、NLR和PLR,使用Logistic回归及受试者操作特征（ROC）曲线分析3项指标在鉴别AIS伴发PFO与非伴发PFO中的价值。结果 伴发PFO的AIS患者SII、NLR、PLR高于非伴发PFO的AIS患者,其中以SII最为明显（P均<0.05）。单因素Logistic回归显示,中性粒细胞计数、淋巴细胞计数、PLR、NLR、SII与AIS伴发PFO有关（P<0.05）。ROC曲线分析结果,SII、NLR、PLR鉴别AIS伴PFO与非伴PFO患者,最佳阈值分别为476.4、1.99、115.3,曲线下面积分别为0.777、0.767、0.708。结论 SII、NLR和PLR可作为鉴别AIS患者是否伴发PFO的生物标志物,具有潜在临床应用价值。

Objective To evaluate the value of systemic immune-inflammatory index（SII）,neutrophil/lymphocyte ratio（NLR）and platelet/lymphocyte ratio（PLR）in distinguishing acute ischemic stroke（AIS）patients with patent foramen ovale（PFO）and without PFO．Methods A retrospective analysis of blood and serum indicators in 100 AIS patients was conducted,and SII,NLR and PLR indices were calculated．Logistic regression and ROC curve analyses were performed．Results SII,NLR and PLR were significantly higher in PFO patients than in non-PFO patients,with SII being the most significant．Univariate logistic regression showed that Neu,Lym,PLR,NLR,and SII variables were significantly associated with AIS combined with PFO（P<0.05）．ROC curve analysis revealed that the optimal cut-off values for SII,NLR and PLR in distinguishing AIS patients with PFO from those without PFO were 476.4,1.99 and 115.3,respectively,with area under the curve of 0.777,0.767 and 0.708．Conclusions SII,NLR and PLR can serve as biomarkers for identifying AIS patients with PFO,offering potential clinical application value．

目的 探讨与分析高频超声联合超微血流成像对肱三头肌肌腱断裂伴骨化性肌炎的诊断价值。方法 选择2020年7月—2022年5月在本院诊治的84例肱三头肌肌腱断裂患者作为研究对象,所有患者均行关节镜及超声检查,超声检查包括高频超声、超微血流成像,记录超声特征并判断诊断价值,根据关节镜检查结果分为骨化性肌炎组和非骨化性肌炎组。结果 84例患者中,经关节镜检查判断为合并骨化性肌炎24例（骨化性肌炎组）,占比28.6%。骨化性肌炎组超声表现为肱三头肌肌腱纤维呈连续性中断,含稍强回声的非均质等回声,近侧断端肌腱有回缩并增厚。非骨化性肌炎组（60例）超声表现为肱三头肌肌腱纤维呈连续性中断,局限性边界清晰非均质性稍低回声,两断端中间呈不均质低回声。骨化性肌炎组的骨质破坏、软组织肿胀与关节积液等占比分别为75.0%、79.2%、79.2%,均高于非骨化性肌炎组的20.0%、25.0%、35.0%（P<0.05）。骨化性肌炎组的肌腱面积、肌腱厚度、血管条数均比非骨化性肌炎组更高（P<0.05）。84例患者中,高频超声、超微血流成像与两者联合诊断为肱三头肌肌腱断裂伴骨化性肌炎分别为18例、23例、24例,高频超声、超微血流成像与两者联合诊断肱三头肌肌腱断裂伴骨化性肌炎的灵敏度为70.8%（17/24）、91.7%（22/24）、100.0%（24/24）,特异度为98.3%（59/60）、98.3%（59/60）、100.0%（60/60）。结论 肱三头肌肌腱断裂伴骨化性肌炎比较常见,高频超声联合超微血流成像在肱三头肌肌腱断裂伴骨化性肌炎的应用可有效反映病灶形态特征与血流特征,在诊断上具有很高的灵敏度与特异度。

Objective To explore and analyze the diagnostic values of high-frequency ultrasound combined with superb microvascular imaging（SMI）in triceps brachii tendon rupture with ossifying myositis．Methods From July 2020 to May 2022,84 cases of patients with triceps brachii tendon rupture who were diagnosed and treated in our hospital were selected as research subjects．All patients underwent arthroscopy and ultrasonography,ultrasonography including high-frequency ultrasound and SMI,to record ultrasound characteristics and determine diagnostic value,and patients were divided into ossifying myositis group and non-ossifying myositis group according to the results of the arthroscopic examination．Results In 84 patients,there were 24 patients（28.6%）diagnosed as ossifying myositis by arthroscopy（ossifying myositis group）．The ultrasound findings of the ossifying myositis group were interruption of the triceps brachii muscle tendon fibers with slightly strong echogenicity and heterogeneous isoechogenicity．The proximal severed tendon had retraction and thickening．In the non-ossifying myositis group（n=60）,the ultrasound findings showed a interruption of the triceps brachii muscle tendon fibers,with clear localized boundaries and slightly heterogeneous hypoechogenicity,and there was an uneven hypoechogenicity between the two broken ends．The proportions of bone destruction,soft tissue swelling and joint effusion in the myositis group were 75.0%,79.2% and 79.2%,which were significantly increased compared to 20.0%,25.0% and 35.0% in the non-ossifying myositis group（P<0.05）．The tendon area,tendon thickness and vascular number in the ossifying myositis group were significantly higher than those in the non-ossifying myositis group（P<0.05）．In the 84 patients,there were 18 cases,23 cases and 24 cases diagnosed of triceps tendon rupture with ossifying myositis by high-frequency ultrasound,SMI and their combination．The sensitivity of high-frequency ultrasound,SMI and their combination in the diagnosis of triceps tendon rupture with ossifying myositis were 70.8%（17/24）,91.7%（22/24） and 100.0%（24/24）,with specificity of 98.3%（59/60）,98.3%（59/60） and 100.0%（60/60）．Conclusions Triceps brachii tendon rupture with ossifying myositis is relatively common．The application of high-frequency ultrasound combined with SMI in triceps brachii tendon rupture with ossifying myositis can effectively reflect the morphological and blood flow characteristics of the lesion,with high sensitivity and specificity in diagnosis．

目的 探索两种常用免疫学指标—结核菌素试验(purified protein derivative skin test, PPD皮试)与结核分枝杆菌γ-干扰素释放试验(tuberculosis-interferon gamma release assay,TB-IGRA)对结核病的辅助诊断价值。方法 收集2017年1月—2021年1月于我中心门诊部就诊的疑似结核病患者资料,共171例,所有病例均行PPD皮试和外周血TB-IGRA。将病例分为结核病组(TB组)和非结核病组(非TB组)。TB组共98例,非TB组共73例。比较两组病例PPD皮试、TB-IGRA对结核病诊断的准确度、敏感度、特异度。结果 TB-IGRA对结核病诊断的准确度、敏感度和特异度分别为94.2%、93.9%和90.4%,PPD皮试对结核病诊断的准确度、敏感度和特异度分别为77.2%、84.7%和76.7%。TB-IGRA的准确度和特异度与PPD皮试比较差异有统计学意义(分别为χ²=20.034,P<0.05和χ²=5.176,P<0.05);TB-IGRA的敏感度高于PPD皮试,但两者比较差异无统计学意义(χ²=0.948,P>0.05)。2组间TB-IGRA结果、PPD皮试结果比较差异均具有统计学意义(分别为χ²=132.77,P<0.01和χ²=47.963 5,P<0.01)。结论 TB-IGRA和PPD皮试均具有良好的结核病辅助诊断价值;TB-IGRA的引进大大提高了诊断试验的准确度和特异度,但仍需要进一步探索其诊断标准以更好地为临床使用。

Objective To explore the auxiliary diagnosis value of two commonly used immunological indicators for tuberculosis, purified protein derivative skin test (PPD test) and tuberculosis-interferon gamma release assay (TB-IGRA). Methods A total of 171 cases of suspected tuberculosis patients who were treated in the outpatient department of our center from January 2017 to January 2021 were collected. All cases underwent PPD test and peripheral blood TB-IGRA. The cases were divided into tuberculosis groups (TB group) and non-tuberculosis group (non-TB group). There were 98 cases in the TB group and 73 cases in the non-TB group. The accuracy, sensitivity, and specificity of PPD test and TB-IGRA for tuberculosis diagnosis were compared between the two groups. Results The accuracy, sensitivity, and specificity of TB-IGRA for tuberculosis diagnosis were 94.2%, 93.9% and 90.4% respectively, which of PPD test for tuberculosis diagnosis were 77.2%, 84.7% and 76.7% respectively. The accuracy and specificity of TB-IGRA were statistically different from those of PPD test (χ²=20.034,P<0.05 and χ²=5.176,P<0.05, respectively). The sensitivity of TB-IGRA was higher than that of PPD test, but the difference was not statistically significant (χ²=0.948,P>0.05). The differences of TB-IGRA and PPD test results between the two groups were statistically significant (χ²=132.77,P<0.01 and χ²=47.9635,P<0.01). Conclusion Both TB-IGRA and PPD test had good auxiliary diagnostic value for tuberculosis; the introduction of TB-IGRA had greatly improved the accuracy and specificity of the diagnostic test, but it is still necessary to further explore its diagnostic criteria to better serve the clinical use.

目的 研究结核感染T细胞斑点试验(T-SPOT.TB)技术联合胸水腺苷脱氨酶(ADA)在结核性胸膜炎中的诊断价值。方法 在研究中选取2016年1月—2018年12月在梅州市人民医院呼吸内科和全科医学科住院的60例结核性胸膜炎患者作为研究对象,对所有患者均进行血T-SPOT.TB、胸水ADA检查,比较血T-SPOT.TB、胸水ADA及胸水ADA联合血T-SPOT.TB检查三种检测方式的诊断符合率、误诊率、漏诊率、阳性预测值、阴性预测值、准确性、特异度、敏感度。结果 胸水ADA、血T-SPOT.TB以及血T-SPOT.TB联合胸水ADA检测方式的诊断符合率分别为75%、80.00%、93.33%,联合检测方式的诊断符合率高于单一检测方式的诊断符合率(P＜0.05)。血T-SPOT.TB联合胸水ADA检测方式的误诊率、漏诊率分别为0.00%、1.72%,低于胸水ADA、T-SPOT.TB检测方式(P＜0.05);血T-SPOT.TB联合胸水ADA检测方式的阳性预测值、阴性预测值分别为100.00%,67.78%,联合检测方式的阴性预测值高于其单一检测方式(P＜0.05)。T-SPOT.TB联合胸水ADA检测方式的特异度及敏感度分别为98.79%、97.87%,联合检测方式的敏感度高于其单一检测方式(P＜0.05)。血T-SPOT.TB检测方式与胸水ADA检测方式仅在特异度方面不存在统计学差异(P＞0.05)。结论 在对结核性胸膜炎患者进行诊断时,血T-SPOT.TB联合胸水ADA具有较高的诊断价值,值得应用。

Objective To investigate the diagnostic value of t-spot test (T-SPOT.TB) combined with adenosine deaminase (ADA) in tuberculous pleuritis. Methods 60 patients with tuberculous pleurisy hospitalized in the departments of respiratory medicine and general practice of Meizhou People's Hospital between January 2016 and December 2018 were enrolled in the study. All the patients were examined by blood T-SPOT.TB and ADA. The diagnostic coincidence rate, false positive rate,false negative rate, positive predictive value, negative predictive value, accuracy, specificity and sensitivity of the three detection methods of T-SPOT.TB, ADA, and T-SPOT.TB combined with ADA were also analyzed. Results The diagnostic coincidence rate of ADA, T-SPOT.TB and T-SPOT.TB combined with ADA was 75%, 80.00% and 93.33%, respectively. The diagnostic coincidence rate of the combined test was higher than that of the detection method (P<0.05). The misdiagnosis rate and missed diagnosis rate of blood T-SPOT.TB combined with ADA were 33.3% and 1.75%, respectively. The positive predictive value and negative predictive value of blood T-SPOT.TB combined with ADA test were 98.2% and 66.6%, respectively. The negative predictive value of combined T-SPOT.TB combined with ADA test was higher than that of the single test (P<0.05). The specificity and sensitivity of the T-SPOT.TB combined with ADA were 98.79% and 97.87%, respectively, and the sensitivity of the combined test was higher than that of the single test (P<0.05). Conclusion Blood T-SPOT.TB combined with pleural effusion ADA has higher diagnostic value in patients with tuberculous pleurisy and is worthy of clinical application.

目的 通过研究统计痰TB-DNA、痰分枝杆菌核酸、痰涂片找抗酸杆菌、血清T-SPOT.TB试验对肺结核的诊断敏感度、特异度、诊断预测值、诊断准确率,进一步探讨不同临床检测方法对肺结核的诊断价值,指导肺结核患者的临床诊治。方法 通过回顾性分析我院2017年1月—2019年12月呼吸内科、感染性疾病科诊断为活动性肺结核的患者,以痰结核菌培养结果为对照标准,分别统计出痰TB-DNA、痰分枝杆菌核酸、痰涂片找抗酸杆菌、血T-SPOT.TB试验对肺结核的诊断敏感度、特异度、阳性预测值、阴性预测值、诊断准确率,探讨我院临床上四种实验室方法对诊断肺结核的临床价值。结果 通过上述方法统计出痰TB-DNA、痰分枝杆菌核酸、痰涂片找抗酸杆菌、血T-SPOT.TB试验对肺结核的诊断敏感度分别是84.7%、88.1%、74.7%、96.0%,特异度分别是65.3%、69.2%、86.5%、17.8%,阳性预测值分别是83.0%、85.%、92.0%、70.7%,阴性预测值分别是68.1%、73.5%、62.1%、68.4%,诊断准确率分别是78.2%、82.0%、78.5%、70.5%。结论 跟传统方法痰结核菌培养、痰涂片找抗酸杆菌比较,TB-DNA、分枝杆菌核酸、TB-SPOT.TB试验在时效、灵敏度方面更具优势,能敏感检测出人体是否感染肺结核,对患者的早期诊断及指导治疗具有重要意义。

Objective To investigate the diagnostic sensitivity, specificity, predictive value and diagnostic accuracy of TB-DNA, mycobacterium sputum nucleic acid, acid-fast bacilli on sputum smear and serum T-SPOT.TB test for tuberculosis, so as to further explore the significance of different clinical detection methods for tuberculosis and guide the clinical diagnosis and treatment of tuberculosis patients. Methods By retrospective analysis of January 2017-December 2019, patients from respiratory medicine, infectious diseases departments diagnosed with active tuberculosis, sputum culture results of tuberculosis bacterium as control standard, we figured out sputum TB-DNA, sputum mycobacterium nucleic acid blood, sputum smear for acid fast bacilli, T-SPOT. TB test to the diagnosis sensitivity, specific degree, positive predictive value, negative predictive value, diagnostic accuracy, to explore the clinical value of four clinical laboratory methods in our hospital. Results According to the above methods, the diagnostic sensitivity of sputum TB-DNA, sputum mycobacterial nucleic acid, sputum acid-fast bacilli on smear and blood T-SPOT.TB test for tuberculosis was 84.7%、88.1%、74.7%、96.0%, and the specificity was 65.3%、69.2%、86.5%、17.8%, respectively. The positive predictive value was 83.0%、86.6%、92.0%、70.7%, and the negative predictive value was 68.1%、73.5%、62.1%、68.4%, respectively. The diagnostic accuracy was 78.2%、82.0%、78.5%、70.5%, respectively. Conclusion Compared with the traditional methods of culture and sputum smear for acid-fast bacilli, TB-DNA, mycobacterial nucleic acid and T-SPOT.TB test had more advantages in terms of timeliness and sensitivity. It is great significance for the early diagnosis and treatment of patients to detect whether they are infected with tuberculosis sensitively.

目的 探讨Napsin A、TTF-1和CK7在恶性胸水细胞蜡块中的表达及对肺腺癌的诊断价值。方法 收集已确诊为恶性胸水且行Napsin A、TTF-1及CK7免疫组化标记,并收集患者的血清和胸水CEA,将患者按组织来源分为肺腺癌组和非肺腺癌组,比较Napsin A、TTF-1、CK7、血清CEA和胸水CEA在两组中的表达和浓度并计算它们的诊断价值。结果 相对于非肺腺癌组,肺腺癌组患者的Napsin A(83.9% vs 16.1%,P<0.001)、TTF-1(93.5% vs 6.5%,P<0.001)和CK7(98.1% vs 1.9%,P<0.001)阳性表达升高。Napsin A诊断肺腺癌的敏感度为83.9%,特异度为93.9%,TTF-1诊断肺腺癌的敏感度为93.5%,特异度为90.9%;CK7诊断肺腺癌的敏感度为98.1%,特异度为42.4%;明显高于传统肿瘤标志物血清CEA(诊断肺腺癌的敏感度为69.7%,特异度为58.5%)和胸水CEA(诊断肺腺癌的敏感度为69.0%,特异度为66.7%)。结论 Napsin A、TTF-1及CK7对于鉴别肺腺癌恶性胸水及其他肿瘤所致的恶性胸水具有较高的诊断价值。

Objective To investigate the expression of Napsin A, TTF-1 and CK7 in paraffin cells block of malignant pleural effusion and their diagnostic value for lung adenocarcinoma. Methods Immunohistochemistry of Napsin A, TTF-1, CK7, serum and pleural fluid CEA were collected from patients with malignant pleural effusion. The patients were divided into lung adenocarcinoma group and non-lung adenocarcinoma groups according to tissue source. The expression of Napsin A, TTF-1, CK7, CEA and the levels of serum and CEA in pleural fluid were compared and their diagnostic value was calculated. Results The positive expression of Napsin A (83.9% vs 16.1%, P<0.001), TTF-1 (93.5% vs 6.5%, P<0.001) and CK7 (98.1% vs 1.9%, P<0.001) in malignant pleural effusion caused by lung adenocarcinoma were higher compared to other tumors. The sensitivity and specificity of Napsin A were 83.9% and 93.9%,the sensitivity and specificity of TTF-1 were 93.5% and 90.9%, and those of CK7 were 98.1% and 42.4%; which were higher than those of serum CEA (69.7% and 58.5%) and pleural fluid CEA (69.0% and 66.7%) respectively. Conclusion Napsin A, TTF-1 and CK7 are of high value in the diagnosis of malignant pleural effusion caused by lung adenocarcinoma from other tumors.

目的 探讨增强T2FAIR系列在结核性脑膜炎(TBM)中的诊断价值。方法 选择临床疑似TBM并初次行MR检查的患者80例,根据TBM诊断评分标准和颅内结核影像学分型专家共识作为临床确诊依据。最终56例经临床确诊为TBM(脑脊液结核杆菌抗酸检测阳性)。行常规系列颅脑扫描后增加增强T2FIR系列扫描。由三位经验丰富从事影像专业诊断不同级别的医师分别进行独立分析诊断,以明显强化、轻度强化和无明显强化对比分析增强三维快速扰相梯度回波T1WI(T1GRE3D-FS)序列和增强T2FIR系列对TBM脑膜病变和脑实质的显示程度。结果 增强T2FLAIR系列52例显示脑膜明显强化占92.5%;4例不明显强化占7.5%。T1GRE3D-FS序列 8例明显强化占14%,39例轻度强化占70%;9例无明显强化占16%。增强T2FLAIR系列43例显示脑实质明显强化占76.8%;13例轻度强化占23.2%。T1GRE3D-FS序列48例明显强化占86%;8例轻度强化占14%。两系列对脑实质的显示均有轻度强化。结论 增强T2FAIR系列可作为TBM早期常规系列用于TBM的MR增强检查,能显著提高TBM影像诊断的准确性,,弥补了常规MR增强TlWI对结核性脑膜炎诊断的不足。

Objective To investigate the diagnostic value of enhanced T2FAIR series in tuberculous meningitis (TBM) patients. Methods 80 patients with suspected clinical TBM and initial MR examination were selected as the basis for clinical diagnosis according to the TBM diagnostic scoring standard and the expert consensus of intracranial tuberculosis imaging classification. Finally,56 cases were clinically confirmed as positive for acid resistance in TBM. Enhanced T2FIR series scans were added after routine series craniocerebral scanning. Independent diagnostic analysis was performed by three experienced imaging specialists. By different levels of diagnosis with significant enhancement, mild enhancement and no mild enhancement, we made contrast analysis in display of enhanced three-dimensional fast scrambling phase gradient echo T1WI (T1GRE3D-FS) sequence and enhanced T2FIR series on TBM meningeal lesions and brain parenchyma. Results 52 cases of enhanced T2FLAIR series showed significant enhancement of the meninges in 92.5%; in 4 cases,7.5% were not significantly enhanced. 8 cases of T1GRE3D-FS sequences were significantly enhanced, accounting for 14%, 39 cases of mild enhancement accounted for 70%; no significant enhancement was found in 9 cases, accounting for 16%. Enhanced T2FLAIR series of 43 cases showed significant enhancement of brain parenchyma accounted for 76.8%; 13 cases of mild enhancement accounted for 23.2%. 48 cases of T1GRE3D-FS sequences were significantly enhanced accounted for 86%; 8 cases of mild enhancement accounted for 14%. Both series showed mild enhancement of brain parenchyma. Conclusion The enhanced T2FAIR series can be used as TBM early routine series for MR enhanced examination, it may significantly improve the accuracy of TBM imaging diagnosis, to make up the deficiency of conventional MR.

目的 探讨血常规、血沉、C-反应蛋白水平对小儿急性肺炎的诊断价值。方法 选取2014年1月—2019年12月我院收治的小儿急性肺炎100例作为研究组,同时根据有无发生感染将其分为感染组(26例)与非感染组(74例),另外选择同期在我院检查的健康儿童100例作为对照组。比较感染组与非感染组血常规、血沉、C-反应蛋白水平、感染组与对照组血常规、血沉、C-反应蛋白水平、非感染组与对照组血常规、血沉、C-反应蛋白水平。结果 感染组中性粒细胞百分比、白细胞计数、C-反应蛋白高于非感染组(P＜0.05),两组血沉对比,无明显差异(P＞0.05);感染组中性粒细胞百分比、白细胞计数、C-反应蛋白、血沉高于对照组(P＜0.05);两组中性粒细胞百分比、C-反应蛋白水平相比,无明显差异(P＞0.05),非感染组白细胞计数、血沉高于对照组(P＜0.05)。结论 小儿急性肺炎的诊断中,对小儿的血常规、血沉、C-反应蛋白水平进行检测对诊断疾病非常重要,值得临床使用。

Objective To investigate the diagnostic value of blood routine, erythrocyte sedimentation rate and C-reactive protein level in children with acute pneumonia. Methods A total of 100 cases of acute pneumonia in children admitted to our hospital from January 2014 to December 2019 were selected as the study group. At the same time, they were divided into an infected group (26 cases) and a non-infected group (74 cases) according to the presence or absence of infection. In addition, 100 healthy children examined in our hospital during the same period were selected as the control group. Blood routine examination, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level were compared between infected and non-infected group; in infection and control group blood routine examination, ESR, C-reactive protein level were compared; in non-infection and control group blood routine examination, ESR, C-reactive protein level were compared. Results The percentage of neutrophils, white blood cell count and C-reactive protein in the infected group were higher than those in the non-infected group (P<0.05). There was no significant difference in erythrocyte sedimentation rate between the two groups (P> 0.05). The percentage of neutrophils, leukocyte count, C-reactive protein and erythrocyte sedimentation rate in the infected group were higher than those in the control group (P<0.05). There was no significant difference in the percentage of neutrophils and C-reactive protein levels between the two groups (P> 0.05), and the white blood cell count and erythrocyte sedimentation rate in the non-infected group were higher than those in the control group (P<0.05). Conclusion In the diagnosis of acute pneumonia in children, it is very important to detect the blood routine, erythrocyte sedimentation rate and C-reactive protein level in children, and it is worthy of clinical use.