王德华

【摘要】 目的：探討CT联合MRI检查对脑梗死合并脑出血的诊断效果。方法：选取2021年6月—2023年5月连云港市第一人民医院收治的86例疑似脑梗死合并脑出血患者作为研究对象。以临床观察和综合检查结果为“金标准”。所有患者均进行常规MRI及CT检查。记录CT、MRI及两者联合的诊断结果，并通过敏感度、特异度、阳性预测值、阴性预测值、准确度和Kappa值评估MRI、CT及两者联合的诊断效能。结果：金标准确诊脑梗死合并脑出血71例，单纯脑出血7例，单纯脑梗死8例。CT检查确诊脑梗死合并脑出血52例，单纯脑梗死或脑出血7例，敏感度、特异度、准确度分别为73.24%、46.67%、68.60%。MRI检查确诊脑梗死合并脑出血55例，单纯脑梗死或脑出血9例，敏感度、特异度、准确度分别为77.46%、60.00%、74.42%。CT联合MRI确诊脑梗死合并脑出血59例，单纯脑梗死或脑出血13例，敏感度、特异度、准确度分别为83.10%、86.67%、83.72%。CT联合MRI检查的特异度、准确度均高于CT检查（P<0.05）。结论：CT联合MRI对脑梗死合并脑出血的诊断效能较高。

【关键词】 脑梗死 脑出血 MRI CT

Diagnostic Value of CT Combined with MRI in Cerebral Infarction Complicated with Intracerebral Hemorrhage/WANG Dehua. //Medical Innovation of China， 2024， 21（08）： -134

[Abstract] Objective： To explore the diagnostic effect of CT combined with MRI on cerebral infarction complicated with cerebral hemorrhage. Method： A total of 86 patients with suspected cerebral infarction complicated with cerebral hemorrhage admitted to the First People's Hospital of Lianyungang from June 2021 to May 2023 were selected as the study objects. Clinical observation and comprehensive examination results was the "gold standard". All patients underwent routine MRI and CT examination. The diagnostic results of CT， MRI and their combination were recorded， and the diagnostic efficacy of MRI， CT and their combination was evaluated by sensitivity， specificity， positive predictive value， negative predictive value， accuracy and Kappa value. Result： The gold standard confirmed 71 cases of cerebral infarction complicated with cerebral hemorrhage， 7 cases of simple cerebral hemorrhage， 8 cases of simple cerebral infarction. CT examination confirmed 52 cases of cerebral infarction complicated with cerebral hemorrhage， 7 cases of simple cerebral infarction or cerebral hemorrhage， and the sensitivity， specificity and accuracy respectively was 73.24%， 46.67% and 68.60%. MRI examination confirmed 55 cases of cerebral infarction complicated with cerebral hemorrhage and 9 cases of simple cerebral infarction or cerebral hemorrhage， and the sensitivity， specificity and accuracy respectively was 77.46%， 60.00% and 74.42%. CT combined with MRI confirmed 59 cases of cerebral infarction complicated with cerebral hemorrhage， 13 cases of simple cerebral infarction or cerebral hemorrhage， and the sensitivity， specificity and accuracy respectively was 83.10%， 86.67% and 83.72%. The specificity and accuracy of CT combined with MRI were higher than those of CT （P<0.05）. Conclusion： The diagnostic efficiency of CT combined with MRI is is high in cerebral infarction complicated with cerebral hemorrhage.

[Key words] Cerebral infarction Cerebral hemorrhage MRI CT

First-author's address： Department of Radiology， the First People's Hospital of Lianyungang， Lianyungang 222000， China

doi：10.3969/j.issn.1674-4985.2024.08.029

脑梗死合并脑出血在病理生理学上具有复杂性和多样性，其诊断是一个复杂的任务[1-2]。随着医疗影像技术的发展，CT和MRI在脑部疾病诊断中扮演着越来越重要的角色，特别是在脑梗死和脑出血的诊断中，这两种技术各自有其独特的优势和局限[3-6]。已有研究证实了CT和MRI联合使用在脑梗死合并脑出血诊断中的价值。郭华峰等[7]、Fiebach等[8]指出，MRI结合CT对于确定脑梗死和脑出血至关重要，MRI能够可视化血管阻塞、缺血和梗死，有助于决定是否进行溶栓治疗。因此，本文的目的是探讨CT联合MRI在脑梗死合并脑出血诊断中的效果，通过比较这两种技术单独使用和联合使用的诊断效能，评估其对提高诊断准确性的贡献。……