评估MRI对诊断胸腰椎骨折患者后部韧带复合体损伤的可靠性  

To Evaluate the Reliability of MRI in the Diagnosis of Posterior Ligament Complex Injury in Patients with Thoracolumbar Fractures

作　　者：李磊[1] 朱建华[1] 江松 LI Lei;ZHU Jian-hua;JIANG Song(Department of Orthopedics,the Ninth People's Hospital of Chongqing,Chongqing 400700,China;Department of Radiology,Chongqing Ping An Medical Imaging Diagnosis Center,Chongqing 400010,China)

机构地区：[1]重庆市第九人民医院骨科,重庆400700 [2]重庆平安医学影像诊断中心放射科,重庆400010

出　　处：《中国CT和MRI杂志》2022年第6期167-169,共3页Chinese Journal of CT and MRI

摘　　要：目的分析MRI对诊断胸腰椎骨折患者PLC(后部韧带复合体损伤)的可靠性。方法随机选定本院2018年1月至2020年1月收治的85例胸腰椎骨折患者PLC患者,分别进行X线、MRI检查,均以手术诊断结果为“金标准”,对比X线以及MRI后部韧带损伤检出率,对比X线以及MRI诊断特异度、灵敏度、阳性预测值、阴性预测值。结果X线检出74例,其中小关节囊损伤19例、占22.35%;黄韧带损伤16例、占18.82%;棘上韧带损伤20例、占23.53%;棘间韧带损伤19例,占22.35%。MRI检出83例,其中小关节囊损伤21例、占24.71%;黄韧带损伤18例、占21.18%;棘上韧带损伤24例、占28.24%;棘间韧带损伤20例,占23.53%。MRI后部韧带损伤检出率(97.65%)明显高于X线(87.06%),P<0.05。MRI诊断特异度(100.00%)、灵敏度(97.62%)、阳性预测值(100.00%)均明显比X线(42.86%、89.47%、95.77%)高,差异有统计学意义(P<0.05)。MRI阴性预测值(33.33%)与X线(42.86%)比较,差异无统计学意义(P>0.05)。结论MRI可显著提高胸腰椎骨折患者PLC检出率,诊断特异度、灵敏度均较高,为治疗方案的制定具有重要的指导价值,值得借鉴。Objective To analyze the reliability of MRI in the diagnosis of PLC(posterior ligament complex injury)in patients with thoracolumbar fracture.Methods 85 patients with thoracolumbar fracture,who were randomly selected from January 2018 to January 2020,were examined by X-ray and MRI respectively.The results of operation diagnosis were taken as the"gold standard".The detection rate of ligament injury,specificity,sensitivity,positive predictive value and negative predictive value of X-ray and MRI were compared.Results 74 cases were detected by X-ray,including 19 cases of small joint capsule injury,accounting for 22.35%;16 cases of ligamentum flavum injury,accounting for 18.82%;20 cases of supraspinous ligament injury,accounting for 23.53%;19 cases of interspinous ligament injury,accounting for 22.35%.83 cases were detected by MRI,including 21 cases of small joint capsule injury,accounting for 24.71%;18 cases of ligamentum flavum injury,accounting for 21.18%;24 cases of supraspinous ligament injury,accounting for 28.24%;20 cases of interspinous ligament injury,accounting for 23.53%.The detection rate of posterior ligament injury in MRI(97.65%)was significantly higher than that in X-ray(87.06%),P<0.05.The specificity(100%),sensitivity(97.62%)and positive predictive value(100%)of MRI were significantly higher than those of X-ray(42.86%,89.47%,95.77%),and the difference was statistically significant(P<0.05).There was no significant difference between MRI negative predictive value(33.33%)and X-ray negative predictive value(42.86%)(P>0.05).Conclusion MRI can significantly improve the detection rate of PLC in patients with thoracolumbar fractures,and has high diagnostic specificity and sensitivity.It has important guiding value for the formulation of treatment plan,and is worth learning.

关 键 词：X线 MRI 胸腰椎骨折 后部韧带复合体损伤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R683.1[医药卫生—诊断学]