MRI联合血清生化指标在急性化脓性骨髓炎诊断中的应用价值  

Application value of MRI combined with serum biochemical indicators in the diagnosis of acute suppurative osteomyelitis

作　　者：李晓艳 LI Xiao-yan(Medical Imaging Center,Xi an International Medical Center Hospital,Xi an 710000,Shaanxi,China)

机构地区：[1]西安国际医学中心医院影像诊疗中心,陕西西安710000

出　　处：《川北医学院学报》2021年第11期1504-1507,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨磁共振成像(MRI)联合血清C反应蛋白(CRP)、降钙素原(PCT)对急性化脓性骨髓炎(ASO)的诊断价值。方法:选取88例ASO患者为ASO组,56名同期健康体检者为健康组。分析ASO患者的MRI影像学特征;比较两组对象及ASO阳性和阴性患者血清CRP及PCT水平;受试者特征工作曲线(ROC)分析MRI联合血清CRP、PCT对ASO的诊断价值。结果:MRI对ASO的检出率为96.59%,其中83例患者发病2 d内可见局部软组织肿胀,软组织界限模糊,T2WI呈略高信号;80例患者发病3 d内可见骨髓异常信号影,T1WI信号稍缩减,T2WI信号稍提升,STIR上更明确,随病程延长,信号变化越显著;85例患者发病6~14 d内可见明显骨质破坏和骨膜反应,表现为骨膜、软组织、肌肉间隙均有不同程度脓肿,长T1呈低信号,长T2呈高信号。ASO组患者血清CRP及PCT水平高于健康组(P<0.05);MRI检出阳性和阴性患者血清CRP、PCT水平比较,差异无统计学意义(P>0.05);ROC曲线分析显示,血清CRP、PCT、MRI及三者联合诊断的曲线下面积(AUC)分别为0.945、0.967、0.983、0.989,联合诊断价值更高。结论:MRI可为该疾病的诊断和治疗提供可靠的影像学依据,MRI联合血清CRP、PCT水平可提高对ASO的诊断价值。Objective:To explore the diagnostic value of magnetic resonance imaging(MRI)combined with serum C-reactive protein(CRP)and procalcitonin(PCT)on acute suppurative osteomyelitis(ASO).Methods:88 patients with ASO were enrolled in the study.All patients underwent MRI and their imaging features were analyzed,and 56 healthy examiners at the same time period were selected as controls.The levels of serum CRP and PCT were compared between the two groups and ASO positive and negative patients,the diagnostic value of MRI combined with serum CRP and PCT in ASO was analyzed by subject characteristic working curve(ROC).Results:The detection rate of ASO by MRI was 96.59%,83 patients showed local soft tissue swelling,fuzzy soft tissue boundary and slightly high signal on T2WI within 2 d of onset,abnormal signal shadow of bone marrow could be seen in 80 patients within 3 d of onset.T1WI signal was slightly reduced,T2WI signal was slightly increased,and STIR was more clear.With the extension of the course of disease,the signal changed more significantly.The levels of serum CRP and PCT of ASO group were higher than those of healthy group(P<0.05).There were no statistical differences in serum CRP and PCT levels between MRI positive detection group and MRI negative detection group(P>0.05).ROC curve showed that the AUC values of serum CRP,PCT,MRI and the combined diagnosis of the three were 0.945,0.967,0.983 and 0.989,respectively,and the combined diagnosis had higher value.Conclusion:MRI can provide a reliable imaging basis for the diagnosis and treatment of this disease.MRI combined with serum CRP and PCT can improve the diagnostic value on ASO.

关 键 词：急性化脓性骨髓炎 磁共振成像 C反应蛋白 降钙素原 联合诊断 

分 类 号：R631.2[医药卫生—外科学]