儿童脑室-腹膜分流并发症的神经影像学研究:德黑兰10年描述性研究。

Q4 Medicine
Open Neuroimaging Journal Pub Date : 2018-01-22 eCollection Date: 2018-01-01 DOI:10.2174/1874440001812010001
Mohammad Vafaee Shahi, Samileh Noorbakhsh, Vida Zarrabi, Banafsheh Nourozi, Leila Tahernia
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引用次数: 8

摘要

背景:脑脊液的产生和吸收之间的任何不匹配都会导致脑积水。在大多数情况下,选择的治疗方法是脑室腹腔分流术。虽然,手术可能有并发症,如感染,分流器故障,硬膜下血肿,癫痫发作和分流器迁移;因此,早期正确发现这些并发症可以获得更好的预后。本研究的目的是评估和比较CT扫描、脑脊液分析和x线摄影在检测分流器并发症和分流器放置问题及住院儿童进一步随访中的效果。方法:回顾性分析德黑兰Rasul Akram医院2006 - 2016年10年间患儿的医疗记录。所有资料记录在准备好的表格上,包括年龄、性别、分流并发症、CT扫描和脑脊液特征。结果:本研究共干扰95例患者,其中男性56例(58.9%),女性39例(41.1%)。并发症发生的平均年龄为2.8±2.2岁。分流梗阻(60%)和感染(25.3%)是最常见的并发症。CT扫描能发现36.5%的分流并发症。CT扫描检测分流梗阻的敏感性为50%,特异性为87%。所有病例均通过CT扫描显示脑出血和血肿。另一方面,CT扫描检测分流感染的敏感性为20%,特异性为60%。分流感染的脑脊液评估显示92%的低血糖,87.5%的细胞增多,62.5%的脑脊液培养阳性。CSF的敏感性为92%,特异性为82%,阳性预测值为63%,阴性预测值为97%。患者的症状和体征有助于获得更高的检测准确性。结论:CT扫描对分流梗阻和感染的检测敏感性和特异性不高,但对出血和血肿的检测非常准确。另一方面,脑脊液的评估是一个可靠的测试,在分流感染的披露。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Neuroimaging Studies in Children with Ventriculoperitoneal Shunt Complications: A 10 Years Descriptive Sudy in Tehran.

Background: Any mismatch between the production and absorption of CSF results in hydrocephalus. In most cases, the selected choice of treatment is the ventriculoperitoneal shunt insertion. Although, the surgery could have complications such as infection, shunt malfunction, subdural hematoma, seizure and Shunt immigration; so, the early and proper detection of these complications could result in better prognosis. The aim of this study was to evaluate and compare the efficacy of CT scan, CSF analysis and X-ray radiography in detection of shunt complications and problems in shunt placement and further follow-up in hospitalized children.

Methods: The medical records of children in Rasul Akram hospital in Tehran were reviewed retrospectively in the last 10 years, from 2006 to 2016. All data were recorded in the prepared form including the age, sex, shunt complication, CT scan and CSF characteristics.

Results: The total number of 95 patients were interfered in this study including 56 males (58.9%) and 39 females (41.1%). The mean age at the onset of complications were 2.8±2.2 years-old. The shunt obstruction (60%) and infection (25.3%) were the most common complications. The CT scan was able to detect 36.5% of shunt complications. The CT scan had the sensitivity and specificity of 50 and 87%, respectively in detection of shunt obstruction. The all cases of brain hematoma and hemorrhage were revealed by CT scan. On the other hand, the CT scan had 20% of sensitivity and 60% of specificity in the detection of shunt infection. The CSF evaluation in shunt infection revealed 92% hypoglycemia, 87.5% pleocytosis, and 62.5% positive CSF culture. CSF had the sensitivity, specificity, positive predictive value and negative predictive value of 92, 82, 63 and 97%, respectively. The patient's symptoms and signs were helpful in obtaining higher test accuracy.

Conclusion: The CT scan was not a good sensitive and specific study in the detection of shunt obstruction and infection, but it was very accurate in detection of hemorrhage and hematoma. On the other hand, CSF evaluation was a reliable test in shunt infection disclosure.

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来源期刊
Open Neuroimaging Journal
Open Neuroimaging Journal Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
0.70
自引率
0.00%
发文量
3
期刊介绍: The Open Neuroimaging Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, and letters in all important areas of brain function, structure and organization including neuroimaging, neuroradiology, analysis methods, functional MRI acquisition and physics, brain mapping, macroscopic level of brain organization, computational modeling and analysis, structure-function and brain-behavior relationships, anatomy and physiology, psychiatric diseases and disorders of the nervous system, use of imaging to the understanding of brain pathology and brain abnormalities, cognition and aging, social neuroscience, sensorimotor processing, communication and learning.
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