头颅CT/MRI 在热性惊厥诊疗中的应用

Application of head CT or MRI in diagnosis and treatment of febrile seizure

摘要:

目的 对热性惊厥（FS）诊疗中头颅CT/MRI 应用情况进行分析，指导临床合理选择影像学方法。方法 调查2012 ～ 2014 年该院FS 住院患者的头颅CT 或MRI 应用情况，分析2 种影像学方法的检查率和图像异常率。结果 头颅影像学检查率为55.0%（238/433），头颅CT 和MRI（含磁共振波谱学）平扫检查率分别为92.4%（220/238）和8.8%（21/238），两者均有为1.3%（3/238）。影像学异常率为20.2%（48/238），CT 和MRI 图像异常率分别为17.7%（39/220）和52.4%（11/21），差异有统计学意义（P <0.05）。单纯性热性惊厥（SFS）和复杂性热性惊厥（CFS）影像学检查率分别为51.7%（165/319）和64.0%（73/114），差异有统 计学意义（P <0.05）。SFS 和CFS 影像学异常率分别为22.4%（37/165）和15.1%（11/73），差异无统计学意义（P >0.05）。结论 在FS 诊治过程中，临床医生应根据FS 类型及个体情况选择合适的影像学方法，避免过度检查。

Abstract:

Objective To analyze the application of head CT or MRI in diagnosis and treatment of febrile seizure (FS) so as to guide reasonable selection of imaging methods in clinic. Methods The application of CT or MRI in head examinations for inpatient with FS in our hospital from 2012 to 2014 were investigated, and the imaging examination rate and the image abnormal rate were analyzed. Results The total rate of head imaging examination for the FS patients was 55.0% (238/433). The examination rates of head CT and MRI (included MRS) plain scan were 92.4% (220/238) and 8.8% (21/238) respectively, among which 1.3% (3/238) of FS cases accepted both CT and MRI plain scan. The abnormal rate of imaging was 20.2% (48/238). The abnormal rates of CT and MRI images were 17.7% (39/220) and 52.4% (11/21) respectively, there was statistically significant difference (P < 0.05). The imaging examination rates of simple febrile seizure (SFS) and complex febrile seizure (CFS) were 51.7% (165/319) and 64.0% (73/114) respectively, and the difference was statistically significant (P < 0.05). The abnormal image rates of SFS and CFS were 22.4% (37/165) and 15.1% (11/73) respectively, and there was no statistical difference (P > 0.05). Conclusions Clinicians should choose an appropriate imaging method according to the type of FS and individual condition in the course of diagnosis and treatment for FS.