CT在评价齿状突加冠综合征患者疼痛中的价值研究  

Application of CT in Evaluating Pain in Patients with Crowned Dens Syndrome

作　　者：曾利川 廖华强[1] 伍文彬[2] 王渠[3] 谢明国[1] Zeng Li-chuan;Liao Hua-qiang;WU Wen-bin;Wang Qu;Xie Ming-guo(.1.Department of Radiology,Hospital of Chengdu University of traditional Chinese Medicine,Chengdu 610072,Sichuan Province,China;Department of Geriatrics,Hospital of Chengdu University of traditional Chinese Medicine,Chengdu 610072,Sichuan Province,China;Department of Ultrasonography,Hospital of Chengdu University of traditional Chinese Medicine,Chengdu 610072,Sichuan Province,China)

机构地区：[1]成都中医药大学附属医院放射科,四川成都610072 [2]成都中医药大学附属医院老年病科,四川成都610072 [3]成都中医药大学附属医院超声科,四川成都610072

出　　处：《中国CT和MRI杂志》2022年第6期36-38,共3页Chinese Journal of CT and MRI

基　　金：四川省干部保健科研项目(No.HGB2019050);成都中医药大学科技发展基金项目(No.18MZ03)。

摘　　要：目的探讨CT值在定量评价齿状突加冠综合征(CDS)患者疼痛的应用价值。方法连续收集我院2015年1月至2019年12月诊断CDS患者。采用视觉模拟评分(VAS)对CDS患者进行疼痛学评分,收集患者C-反应蛋白(CRP)、体温等临床资料。采用64层多排螺旋CT扫描,分别由两名有经验的放射科医师测量齿状突周围韧带及软组织的高密度病灶CT值。分析CDS患者高密度区平均CT值与VAS评分、CRP水平、体温等临床资料的相关性。结果共纳入25例CDS患者,其中男性11例,女性14例,年龄58.3~89岁,平均年龄75.8岁。患者均为急性起病,发病时间1~5d,平均时间3.5d;伴有颈部活动明显受限15例,发热18例。CRP:(12.5±6.3)mg/dL,体温:(37.5±0.8)℃,VAS评分:6.2±3.3。两观察这测量一致性检验结果:κ值为0.8,提示两观测者测量值具有较好一致性。患者的齿状突周围高密度病灶平均CT值为(552.3±120.4)HU。统计分析显示其平均CT值与CRP水平呈中等正相关(r=0.635,P=0.001),与VAS评分及体温均无明显相关性(P>0.05)。结论CT在评价CDS患者具有重要临床价值,齿状突周围韧带CT值与血清C反应蛋白水平呈正相关,但与患者疼痛评分无明显相关性,患者疼痛可能与多种因素相关。Objective To explore the application of CT value in quantitative evaluation of pain in patients with crowded dens syndrome(CDS).Methods Crowded dens syndrome patients were enrolled in this study from January 2015 to December 2019.Visual analog scale(VAS)was used to evaluate the pain of patients with CDS.The clinical data of C-reactive protein(CRP)and body temperature were collected.64 slice multi-slice spiral CT scanning was used.Two experienced radiologists measured the CT value of hyperdensity lesions of ligament and soft tissue around the odontoid process independently.The correlation between the mean CT value of hyper-density area and VAS score,CRP level and body temperature was analyzed.Results A total of 25 patients were enrolled,including 11 males and 14 females,aged 58.3-89 years,with an average age of 75.8 years.All patients were acute onset,the onset time was 1-5 days,the average time was 3.5 days;15 cases were complain of neck stiffness,18 cases of fever.CRP:(12.5±6.3)mg/dl,body temperature:(37.5±0.8)℃,VAS score:6.2±3.3.The kappa value was 0.8,indicating that the two observers had good consistency.The mean CT value surrounding the odontoid process was(552.3±120.4)HU.Statistical analysis showed that the mean CT value was positively correlated with CRP level(r=0.635,P=0.001),but not with VAS score and body temperature(P>0.05).Conclusion CT has important clinical value in the evaluation of patients with CDS.The CT value of periodontoid is positively correlated with serum C-reactive protein level,but has no significant correlation with pain score of patients.

关 键 词：齿状突加冠综合征 疼痛 计算机断层摄影 

分 类 号：R445.3[医药卫生—影像医学与核医学]