소아청소년 환자에서 뇌 MRI의 유용성에 대한 연구
The Effectiveness of Brain Magnetic Resonance Imaging in Pediatric Patients with various neurologic symptoms
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목적:소아청소년 환자들을 대상으로 주증상별 뇌MRI의 병적 그리고 양성 이상 결과의 빈도와 수율(yieldrate)를 후향적으로 분석하고자 하였다 . 방법: 2010년 1월 1일부터 2014년 12월 31일까지 5년의 기간 동안 전북대학교병원 소아청소년과의 외래,입원실,응급실에서 만20세 미만의 환아를 촬영한 뇌MRI중 1,686건을 후향적으로 분석하여 결과를 도출하였다 . 결과: 총 918명(54.4%)에서 이상소견을 보였으며, 407명(24.1%)에서병적소견,597명(35.4%)에서 양성소견을 보였다 .병적소견 중 근긴장저하 10명(83.3%)와 대두증 19명(65.5%)이 높은 수율을 보였다 .전체 479건의 병적 이상 소견 중 측뇌실확장이 103건(21.5%)으로 가장 많은 빈도를 보였다 . 총 697건의 양성 소견 중에는 뇌 주변 조직의염증성 병변이 591건(84.8%)으로 가장 많은 빈도를 보였으며, 이 중 부비동염 462건으로 가장 많았다 . 결론: 이 결과는 임상의들이 높은 수율을 보이는 임상증세에 대한뇌 MRI 촬영을 우선으로 고려하고, 상대적으로 낮은 수율을 보이는 증세에 대하여는 MRI 검사 처방에 좀 더 신중을 기하는데 도움이 될수있다 .
Abstract
Purpose: The aim of this study was to analyze the reasons of taking brain magnetic resonance imaging (MRI), determine the prevalence of the abnormal findings on the images and calculate the yield rate according to the symptoms in pediatric patients with the various neurologic conditions. Method: We retrospectively analyzed a total of 2,398 pediatric patients aged 0-19 years underwent a brain MRI at Chonbuk National University Hospital from January 2010 to December 2014. Two hundreds and seventy eight patients who were diagnosed with precocious puberty and 434 patients who were on follow up of previously diagnosed diseases were excluded. A total of 1,686 MRI scans was used to make the result of the study. The chief complaints were recorded by reviewing charts. The abnormalities found on MRI were divided into benign or pathologic findings and the yield rate was calculated respectively. Results: The most frequent reason to take brain MRI was seizure, 657 (39.0%) followed by headache, 293 (17.4%) and central nervous system infection, 142 (8.4%). The patients with abnormal findings were categorized into two groups as follows: 407 (24.1%) had pathologic findings, 511(30.3%) had benign findings. When we consider patients with both pathologic and benign findings, the patients with benign findings are even more 597 (35.4%). The symptoms with relatively high yield rate in the pathologic findings were hypotonia, macrocephaly and central nervous system infection. Conclusion: Our data may help clinicians make a decision of ordering brain MRI for pediatric patients with various neurologic conditions.
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