本文選題：Creutzfeldt-Jakob病 + 彌散加權(quán)成像　； 參考：《解放軍醫(yī)學(xué)雜志》2017年05期

【摘要】：目的研究散發(fā)性Creutzfeldt-Jakob病(sCJD)患者在病程的不同時(shí)期時(shí)各項(xiàng)輔助檢查手段的敏感性。方法回顧性分析53例sCJD患者的臨床資料,統(tǒng)計(jì)病程不同時(shí)期頭顱核磁彌散加權(quán)像(DWI)、24h動(dòng)態(tài)腦電圖(EEG)、腦脊液14-3-3蛋白及正電子發(fā)射計(jì)算機(jī)斷層顯像(PET-CT)的敏感性。在計(jì)算某一檢測(cè)手段的敏感性時(shí),以特異性臨床表現(xiàn)結(jié)合2項(xiàng)或以上輔助檢查陽(yáng)性結(jié)果作為診斷的公認(rèn)標(biāo)準(zhǔn)。結(jié)果在53例sCJD患者中,列入病程早期、中期及晚期統(tǒng)計(jì)的例數(shù)分別為24、53、22例(其中部分患者跨越2或3個(gè)時(shí)期)。隨病程進(jìn)展,DWI敏感性(早期:58.3%;中期:84.6%;晚期:94.7%)、EEG敏感性(早期:45.8%;中期:62.7%;晚期:77.8%)、腦脊液14-3-3蛋白的敏感性(早期:11.1%;中期:52.9%)及PET-CT的敏感性(早期:80%;中期:100%)均逐漸增高。除晚期未行PET-CT檢查外,其他各期PET-CT的敏感性均優(yōu)于其他輔助檢查。結(jié)論 sCJD患者在病程不同時(shí)期各輔助檢查的敏感性不同,在病程不同階段進(jìn)行多次復(fù)查可提高診斷的敏感性。PET-CT檢查的敏感性較高,結(jié)合其他檢查手段診斷sCJD可起到較為關(guān)鍵的作用。
[Abstract]:Objective to study the sensitivity of adjuvant examination in patients with sporadic Creutzfeldt-Jakob disease at different stages of disease course.Methods the clinical data of 53 patients with sCJD were analyzed retrospectively. The sensitivity of DWI-weighted brain magnetic diffusion weighted imaging (DWI), 14-3-3 protein in cerebrospinal fluid (CSF) and PET-CTs were analyzed.In calculating the sensitivity of a test method, the specific clinical manifestations combined with 2 or more positive results of auxiliary tests are accepted as diagnostic criteria.Results among the 53 patients with sCJD, 22 cases were included in the early, middle and late stage of sCJD.With the progression of the course of the disease, the sensitivity of DWI (early: 94.78.3; mid-stage: 84.6; late: 45.8; mid-stage: 62.7; late: 77.8); the sensitivity of cerebrospinal fluid 14-3-3 protein (early 11.11: 1; mid-stage 52.9) and the sensitivity of PET-CT (early: 80; mid-range: 100th) increased gradually.The sensitivity of PET-CT in other stages was superior to that of other adjuvant examinations except for late PET-CT.Conclusion the sensitivity of various adjuvant examinations in different stages of sCJD patients is different, and repeated reexamination at different stages of the disease course can improve the sensitivity of diagnosis.The diagnosis of sCJD combined with other examination methods can play a more important role.
【作者單位】： 解放軍總醫(yī)院神經(jīng)內(nèi)科;
【基金】：解放軍總醫(yī)院“百項(xiàng)優(yōu)勢(shì)”項(xiàng)目“中國(guó)人亞急性海綿狀腦病早期診療規(guī)范” 解放軍總醫(yī)院2016臨床科研扶持基金項(xiàng)目(2016FC-CXYY-1002)~~
【分類號(hào)】：R741
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本文編號(hào)：1758447