计算机体层成像和磁共振成像对脊柱结核的诊断效果对比研究  

A Comparative Study of CT and MRI in the Diagnosis of Spinal Tuberculosis

作　　者：巫志勇[1] WU Zhi-yong(Beijing Mentougou District Hospital,Beijing 102300)

机构地区：[1]北京市门头沟区医院,北京102300

出　　处：《中国医疗器械信息》2021年第3期54-56,共3页China Medical Device Information

摘　　要：目的:探讨计算机体层成像(CT)和磁共振成像(MRI)对脊柱结核的诊断效果的差异性,为提高脊柱结核的诊断准确率和改善预后提供指导依据。方法:收集2008年6月~2015年6月在门头沟区医院经手术病理和/或临床治疗随访确证的脊柱结核患者的病例信息,回顾性对比分析患者CT和MRI影像诊断结果。结果:利用CT对以上患者开展的检查显示,研究对象椎体骨质破坏、椎间盘受累、椎旁软组织/椎旁脓肿、硬膜囊和脊髓受累,以及细块状死骨形成数量和占研究对象的比例依次为19例(95.0%)、14例(70.0%)、15例(75.0%)、2例(10.0%)和7例(35.0%),而利用MRI对患者检查发现的以上5种病变数量和比例依次为20例(100%)、19例(95.0%)、20例(100%)、7例(35.0%)、0例(0.0%)。McNemar配对χ^(2)检验分析显示,CT对死骨形成的检出率(35%,0)显著高于MRI(P<0.05),而MRI对椎体骨质破坏(100.0%,95.0%)、椎旁脓肿/椎旁软组织受累(95.0%,70.0%)、硬膜囊/脊髓受累(100.0%,75.0%)和椎间盘受累(35.0%,10.0%)的检出率显著高于CT(P均<0.05)。结论:针对脊柱结核病变检测CT及MRI各有优缺点,可互补检查以提高脊柱结核的诊断准确率。Objective:To explore the difference between CT and MRI in the diagnosis of spinal tuberculosis,so as to provide guidance for improving the diagnosis accuracy and prognosis of spinal tuberculosis.Methods:From June 2008 to June 2015,the case information of spinal tuberculosis confirmed by operation,pathology and/or clinical treatment and follow-up in Mentougou District Hospital was collected,and the CT and MRI imaging diagnosis results were analyzed retrospectively.Results:The CT examination of the above patients showed that 19 cases(95.0%),14 cases(70.0%),15 cases(75.0%)and 2 cases(10.0%)were involved in vertebral bone destruction,intervertebral disc involvement,paravertebral soft tissue/paravertebral abscess,dural sac and spinal cord involvement,as well as the number and proportion of the formation of dead bone mass and 7 cases(35.0%),and the number and proportion of the above five lesions detected by MRI were 20 cases(100%),19 cases(95.0%),20 cases(100%),7 cases(35.0%)and 0 case(0.0%).McNemar paired chi square analysis showed that the detection rate of CT for dead bone formation(35%,0)was significantly higher than that of MRI(P<0.05),while MRI for vertebral bone destruction(100.0%,95.0%),paravertebral abscess/paravertebral soft tissue involvement(95.0%,70.0%),dural sac/spinal cord involvement(100.0%,75.0%)and intervertebral disc involvement(35.0%,10.0%)was significantly higher than that of CT(P<0.05).Conclusion:According to the advantages and disadvantages of CT and MRI in the detection of spinal tuberculosis,complementary examination can be used to improve the diagnostic accuracy of spinal tuberculosis.

关 键 词：脊柱结核 计算机体层成像(CT) 磁共振成像(MRI) 

分 类 号：R445.2[医药卫生—影像医学与核医学]