螺旋CT三维成像在脊柱骨折术前诊断及术后骨密度评估中的价值  

Value of Three-Dimensional Spiral CT in Preoperative Diagnosis of Spinal Fracture and Postoperative Evaluation of Bone Mineral Density

作　　者：唐崧杰 崔红旺 王挺锐[1] TANG Song-jie;CUI Hong-wang;WANG Ting-rui(Department of Spinal Osteopathy,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,China)

机构地区：[1]海南医学院第一附属医院脊柱骨病外科,海口570102

出　　处：《南昌大学学报（医学版）》2023年第2期35-39,共5页Journal of Nanchang University：Medical Sciences

基　　金：国家自然科学基金地区项目(81760260)。

摘　　要：目的分析螺旋CT三维成像在脊柱骨折术前诊断及术后骨密度评估中的应用价值。方法采用随机抽样法选取海南医学院第一附属医院脊柱骨折患者85例。患者术前均行螺旋CT三维成像、MRI与X线检查,比较3种检查方式对脊柱骨折诊断和良恶性骨折鉴别的准确性,分析螺旋CT三维成像时患者的未骨折邻椎、术椎术前与术后1个月的CT值。结果螺旋CT三维成像对骨折椎节、骨折位置、稳定性骨折诊断的准确性均高于X线和MRI检查(均P<0.05),对爆裂骨折、椎管狭窄诊断的准确性高于X线检查(P<0.05);螺旋CT三维成像鉴别恶性脊柱骨折准确度(91.76%)均较X线检查(69.41%)和MRI(78.82%)高(P<0.05),其灵敏度和特异度均高于X线检查[(92.68%比73.17%)和(90.91%比65.91%),均P<0.05];术椎术前的CT值小于其术后和未骨折邻椎的CT值(均P<0.05),而未骨折邻椎与术椎术后CT值比较,其差异无统计学意义(P>0.05)。结论螺旋CT三维成像在脊柱骨折的术前诊断上较X线和MRI检查准确性更高,且可较好地评估脊柱骨折患者术后的骨密度。Objective To analyze the value of three-dimensional spiral CT in preoperative diagnosis of spinal fracture and postoperative evaluation of bone mineral density.Methods Eighty-five patients with spinal fracture admitted to the First Affiliated Hospital of Hainan Medical College were selected by random sampling method.All the patients were subjected to three-dimensional spiral CT,magnetic resonance imaging(MRI)and X-ray examination before surgery.The accuracy rates of the three examination methods in the diagnosis of spinal fracture and in the differential diagnosis of benign and malignant fractures were comparatively analyzed.The mean CT values of the adjacent unaffected vertebrae and the surgical vertebrae were detected before and 1 month after surgery.Results Three-dimensional spiral CT was more accurate than X-ray and MRI in the diagnosis of fractured vertebral segment,fracture location and stable fracture(P<0.05),as well as than X-ray in the diagnosis of burst fracture and spinal stenosis(P<0.05).The diagnostic accuracy of three-dimensional spiral CT for malignant spinal fracture(91.76%)was higher than that of X-ray(69.41%)or MRI(78.82%)(P<0.05).The sensitivity and specificity of three-dimensional spiral CT(92.68%and 90.91%,respectively)were also higher than those of X-ray(73.17%and 65.91%,respectively)(P<0.05).The CT value of the surgical vertebrae before surgery was lower than that after surgery,as well as than the CT value of the adjacent vertebrae(P<0.05).However,there was no significant difference in the CT value between the adjacent vertebrae and the surgical vertebrae after surgery(P>0.05).Conclusion Three-dimensional spiral CT is more accurate than X-ray and MRI in preoperative diagnosis of spinal fracture,and can be used for postoperative evaluation of bone mineral density.

关 键 词：脊柱骨折 螺旋CT三维成像 MRI 诊断 骨密度 评估 

分 类 号：R816.8[医药卫生—放射医学]