Study on the application of CT and MRI combined with cerebrospinal fluid inflammatory markers in early risk assess-ment of intracranial infection after craniocerebral surgery

LIANG Panpan; YU Aimei; DU Jing; KOU Wenhui; WANG Huanhuan; SONG Aixia

doi:10.20258/j.cnki.1006-9011.2025.09.003

Abstract：Objective To explore the application value of CT and MRI combined with cerebrospinal fluid inflammatory marker levels in early risk assessment of intracranial infection after craniocerebral surgery.Methods The clinical data of 217 patients with suspected intracranial infection after craniocerebral surgery in our hospital were selected.Cerebrospinal fluid bacte-rial culture results were used as the"gold standard",among which 93 cases were confirmed with infection and 124 cases were not confirmed with infection,divided into an infection group of 93 cases and a non-infection group of 124 cases,correspondingly.All patients underwent CT and MRI examinations after surgery,and cerebrospinal fluid inflammatory marker levels were detected.CT and MRI examination results and cerebrospinal fluid inflammatory marker levels were compared between the two groups,and ROC curve analysis was used to evaluate the value of individual and combined tests.Results CT examination confirmed 73 positive cases with a sensitivity of 62.37%,specificity of 87.90%,positive predictive value of 79.45%,negative predictive value of 75.69%,false positive rate of 12.10%,false negative rate of 37.63%,and diagnostic accuracy of 76.96%;MRI examination confirmed 85 positive cases with a sensitivity of 77.42%,specificity of 89.52%,positive predictive value of 84.71%,negative predictive value of 84.09%,false positive rate of 10.48%,false negative rate of 22.58%,and diagnostic accuracy of 84.33%,re-spectively.The levels of PCT,IL-6,and CRP in the infection group were significantly higher than those in the non-infection group,with statistically significant differences(t=15.869,16.743,21.627,all P<0.05).There were 100 PCT-positive cases,94 IL-6-positive cases,and 86 CRP-positive cases;the AUC were 0.967,0.950,and 0.947,respectively.Individual and combined diagnostic analysis showed that the AUC for CT alone was 0.751,the AUC for MRI alone was 0.835,the AUC for PCT alone was 0.973,the AUC for IL-6 alone was 0.902,the AUC for CRP alone was 0.962,and the AUC for combined diagnosis was 0.844.Conclusion CT and MRI combined with cerebrospinal fluid inflammatory marker levels have good prospects in the diagnosis of intracranial infection after craniocerebral surgery,and combined diagnosis helps to improve the sensitivity and specificity of early diagnosis of intracranial infection.