多层螺旋CT与彩色多普勒超声检查辅助诊断骨与关节结核的对比研究  

Comparative study of multislice spiral CT and color Doppler ultrasonography in the diagnosis of bone and joint tuberculosis

作　　者：赵铁牛 姜爽爽 黄莉 胡雪梅 ZHAO Tie-niu;JIANG Shuang-shuang;HUANG Li;HU Xue-mei(Depxartment of Radiology,924th Hospital of the,Joint Service Support Force of the Pople’8 Liberatio Army,Guilin 541002,China)

机构地区：[1]解放军联勤保障部队第九二四医院放射诊断科,桂林541002 [2]北京结核病控制研究所门诊部 [3]解放军联勤保障部队第九二四医院超声科,桂林541002

出　　处：《中国防痨杂志》2020年第8期845-849,共5页Chinese Journal of Antituberculosis

摘　　要：目的对比多层螺旋CT检查(简称"CT检查")与彩色多普勒超声检查(简称"超声检查")辅助诊断骨与关节结核的效果。方法回顾性分析2015年1月至2019年12月解放军联勤保障部队第九二四医院经手术病理(9例)、细菌学检查(10例)及临床(4例)诊断为骨与关节结核的患者,共计23例。其中,单纯性骨结核12例,单纯性滑膜结核9例,全关节结核2例。所有患者均进行了CT检查与超声检查,对比分析两种检查技术对各型骨与关节结核的辅助诊断情况。结果CT检查诊断为骨与关节结核的正确诊断率为65.2%(15/23),超声检查诊断为骨与关节结核的正确诊断率为56.5%(13/23),两者比较差异无统计学意义(χ^2=0.365,P=0.546)。对于单纯性骨结核患者的诊断,CT检查的正确诊断率(83.3%,10/12)明显高于超声检查(33.3%,4/12),差异有统计学意义(χ^2=6.171,P=0.013);对于9例单纯性滑膜结核患者的诊断,超声检查正确诊断出8例,CT检查正确诊断出3例;对于2例全关节结核患者的诊断,CT检查均做出了正确诊断,超声检查正确诊断出1例。结论对于单纯性骨结核,CT检查的诊断正确率优于超声检查;但对于单纯性滑膜结核,超声检查的诊断正确率优于CT检查。Objective To compare the effect of multislice spiral CT examination(CT examination)and color Doppler ultrasound(ultrasound examination)in the diagnosis of bone and joint tuberculosis.Methods Twentythree cases of bone and joint tuberculosis from January 2015 to December 2019 were retrospectively analyzed.These cases were diagnosed by surgical pathology(9 cases),bacteriological diagnosis(10 cases)and clinical diagnosis(4 cases).Among them,there were 12 cases of simple bone tuberculosis,9 cases of simple synovial tuberculosis,and 2 cases of total joint tuberculosis.CT examination and ultrasound examination were performed in all patients,and the diagnostic value of the two examination techniques for various types of bone and joint tuberculosis was analyzed.Results Accuracy of CT diagnosis of bone and joint tuberculosis was 65.2%(15/23)and ultrasound was 56.5%(13/23).There was no significant statistical difference between them(χ^2=0.365,P=0.546).Accuracy of CT diagnosis of simple bone tuberculosis(83.3%,10/12)was significantly higher than ultrasound(33.3%,4/12),and there was significant statistical difference between them(χ^2=6.171,P=0.013).In 9 cases of synovial tuberculosis,ultrasound correctly diagnosed 8 cases,CT correctly diagnosed 3 cases.In 2 cases of total joint tuberculosis,CT correctly diagnosed 2 cases,ultrasound correctly diagnosed 1 case.Conclusion For simple bone tuberculosis,CT examination is better than ultrasound.For simple synovial tuberculosis,ultrasound examination is better than CT examination.

关 键 词：结核 骨关节 体层摄影术 螺旋计算机 超声检查 多普勒 彩色 对比研究 

分 类 号：R445.1[医药卫生—影像医学与核医学] R816.8[医药卫生—诊断学] R529.2[医药卫生—临床医学]