多层螺旋CT与X线平片诊断老年腰椎退行性病变价值分析  

Diagnostic Value of Multi-slice Spiral CT and X-ray Films for Degenerative Lumbar Lesions in the Elderly

作　　者：司福军 谈伟[1] 侯佳[1] SI Fu-jun;TAN Wei;HOU Jia(Department of Functional Examination,Sichuan Orthopedic Hospital,Chengdu 610000,Sichuan Province,China)

机构地区：[1]四川省骨科医院功能检查科,四川成都610000

出　　处：《中国CT和MRI杂志》2021年第3期159-161,共3页Chinese Journal of CT and MRI

摘　　要：目的观察多层螺旋CT(MSCT)与X线平片对老年腰椎退行性病变的诊断价值。方法选取2018年1月至2019年3月我院影像科接收的疑似老年腰椎退行性病变患者88例,接受X线平片与MSCT检查,观察MSCT与X线平片的影像学表现,比较单项检测与联合检测的阳性检出率、阴性检出率、准确率、灵敏度及特异度的情况。结果 88例患者中,52例确诊为老年腰椎退行性病变。MSCT扫描表现为腰椎间盘呈不同程度的彭突,椎管变小变窄,侧隐窝局部变形,有点状高密度影掺杂在小片云状低密度影中;X线片扫描表现为腰椎间隙有梭形样变,皮质变薄,腰椎间盘呈不同程度的侧弯,间隙变得宽窄不等,骨质密度降低;MSCT与X线平片联合检测的阳性检出率、阴性检出率与单项检测无显著差异(P>0.05);MSCT与X线平片联合检测的漏诊率低于单项检测(P<0.05);MSCT单项检测的误诊率低于X线平片单项检测(P<0.05);MSCT与X线平片联合检测的准确率、敏感度、特异度均高于单项检测(P<0.05)。结论 MSCT与X线平片对老年腰椎退行性病变均有良好的诊断效果,可作为老年腰椎退行性病变早期诊断的有效方法 ,且MSCT的检查准确率、敏感度、特异度更高。Objective To observe diagnostic value of multi-slice spiral CT(MSCT) and X-ray films for degenerative lumbar lesions(DLL) in the elderly.Methods During the period from January 2018 to March 2019,88 elderly patients suspected with DLL who were admitted to Imaging Department of the hospital were enrolled.All underwent X-ray films and MSCT examination.The imaging findings of MSCT and X-ray films were observed.The positive and negative detection rate,accuracy,sensitivity and specificity of single test and combined test were compared.Results Of 88 patients,there were 52 cases confirmed with DLL.MSCT scan found that lumbar intervertebral disc showed protrusion of different degree,the spinal canal became small and narrow,the lateral crypt was locally deformed,and there were punctiform high-density shadows doped in cloud-like low-density shadows.X-ray scan found that there were fusiform changes in lumbar intervertebral space,cortex became thin,lumbar intervertebral disc showed lateral curvature of different degree,the size of space became different,and bone density was decreased.There was no significa nt difference in positive detection rate or negative detection rate between MSCT combined with X-ray films and their single detection(P>0.05).The missed diagnosis rate of combined detection was lower than that of single detection(P<0.05).The misdiagnosis rate of MSCT was lower than that of X-ray film(P<0.05).The accuracy,sensitivity and specificity of MSCT combined with X-ray films were higher than those of single detection(P<0.05).Conclusion Both MSCT and X-ray films are of good diagnostic effect on elderly DLL,which can be applied as effective methods for early diagnosis of elderly DLL However,accuracy,sensitivity and specificity of MSCT detection a re higher.

关 键 词：多层螺旋CT X线平片 老年腰椎退行性病变 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R323.33[医药卫生—诊断学]