CT在血友病髂腰肌血肿误诊中的应用价值分析  

Application value of CT in misdiagnosis of hemophilia iliopsoas hematoma

作　　者：李英 伊慧明 LI Ying;YI Huiming(Department of Radiology,Hematology Hospital,Chinese Academy of Medical Sciences,Tianjing 300020,P.R.China)

机构地区：[1]中国医学科学院血液病医院放射科

出　　处：《医学影像学杂志》2019年第9期1556-1560,共5页Journal of Medical Imaging

摘　　要：目的探讨CT在血友病髂腰肌血肿误诊中的应用价值。方法选取我院收治的血友病患者90例作为研究对象,分为对照组及研究组,对照组使用超声诊断方式,研究组采用CT进行检查,对比两种检出结果。结果通过不同的诊断方法,在左侧髂腰肌出血、双侧髂腰肌出血以及右侧髂腰肌出血方面研究组居多,研究组患者经过CT检查出血率为75.6%,对照组采用超声检查的出血率为48.9%,两组结果差别明显(P<0.05);两组患者经超声和CT分别扫描诊断后,血肿表现具体如下:研究组患者的髂腰肌段16例、腰大肌段16例、腰大肌和髂肌汇合段10例、血肿累及腰大肌和髂肌汇汇合段9例,明显多于对照组(P<0.05);经分别诊断后两组患者的诊断结果显示90例患者中研究组急性期血肿、亚急性期血肿、慢性期血肿的例数明显多于对照组,且对照组患者中并未完全诊断出血肿情况,误诊和疑诊例数明显少于对照组(P<0.05),即研究组患者的诊断符合率明显高于对照组(P<0.05);研究组使用CT检查,敏感度、特异性及准确三方面都显著优于对照组(P<0.05)。结论采用CT对血友病髂腰肌患者的血量情况进行诊断可以观察到患者髂腰肌内的块状或结节状的血肿影,可以对血运情况进行准确评价,诊断结果优于超声检查。Objective To explore the application value of CT in misdiagnosis of hemophilia iliopsoas hematoma.Methods 90 hemophilia patients admitted to our hospital from March 2014 to February 2017 were selected as the research objects.They were divided into control group and study group according to the principle of voluntary.The control group used ultrasonic diagnosis method and the study group used CT to carry out examination and diagnosis.The results of the two diagnosis methods were compared,including the location,shape,size,density and surrounding tissue of hematoma,and the results of the two methods were analyzed.Results Through different diagnostic methods,the majority of patients in the study group suffered from left iliopsoas bleeding,bilateral iliopsoas bleeding and right iliopsoas bleeding.The bleeding rate of patients in the study group after CT examination was 75.6%,while that of the control group was 48.9%.The difference between the two groups was obvious(P<0.05).After ultrasonic and CT scan respectively,the specific manifestations of hematoma in the two groups were as follows:16 cases in the iliopsoas muscle segment,16 cases in the psoas muscle segment,10 cases in the confluence of the psoas muscle and iliopsoas muscle,9 cases in the confluence of the psoas muscle and iliopsoas muscle involved in the hematoma,which was significantly more than that in the control group(P<0.05).The diagnosis results of the two groups showed that the number of cases of acute stage hematoma,subacute stage hematoma and chronic stage hematoma in the study group was significantly higher than that in the control group,and the number of cases of misdiagnosis and suspected diagnosis in the control group was significantly lower than that in the control group(P<0.05),i.e.the diagnostic coincidence rate of the patients in the study group was significantly higher than that in the control group(P<0.05).The sensitivity,specificity and accuracy of CT examination in the study group were significantly better than those in the control group(P<0

关 键 词：血友病 髂腰肌血肿 误诊 体层摄影术 X线计算机 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学]