CT和MRI对腰椎小关节退变患者的诊断价值及其影像学检测结果分析  

Diagnostic value of CT and MRI in patients with lumbar facet joint degeneration and analysis of imaging results

作　　者：徐凡 周珏 刘赤岩 XU Fan;ZHOU Jue;LIU Chiyan(Department of Medical Imaging,Xisai Mountain Aikang Hospital,Huangshi,Hubei,435000,China)

机构地区：[1]黄石市西塞山区爱康医院医学影像科,湖北黄石435000

出　　处：《当代医学》2023年第10期143-145,共3页Contemporary Medicine

摘　　要：目的分析CT和MRI对腰椎小关节退变患者的诊断价值及其影像学检测结果。方法选取2018年5月至2020年10月本院骨科及中医康复科收治的720例腰椎小关节退变患者为研究对象,所有患者均经CT及MRI检查,比较CT及MRI成像对腰椎小关节退变患者关节病变、关节囊或滑膜囊病变及关节滑脱的检出情况。结果720例腰椎小关节退变患者共980个病变关节,其中MRI检出893个,CT检出905个,两种检查方式诊断灵敏度、阳性预测值、准确度比较差异均无统计学意义。MRI关节真空征、关节面增生、关节脱位、黄韧带钙化、关节面平整度、小关节突骨质、关节突骨折检出率均显著低于CT,关节面下软骨退变检出率显著高于CT,差异有统计学意义(P<0.05)。结论CT、MRI对腰椎小关节退变的诊断价值无明显差异,CT适用于硬组织病变的诊断,而MRI适用于软组织病变的诊断,因此临床可将两者结合用于腰椎小关节退变患者的诊断,提高不同病变患者的检出率。Objective To analyze the diagnostic value and imaging results of CT and MRI in patients with lumbar facet joint degeneration.Methods 720 patients with lumbar facet joint degeneration admitted to the department of Orthopedics and Rehabilitation of Traditional Chinese Medicine in our hospital from May 2018 to October 2020 were selected as the study subjects,all patients were examined by CT and MRI,and the detection of joint lesions,joint capsule or synovial capsule lesions and joint slip in patients with lumbar facet joint degeneration were compared between CT and MRI imaging.Results A total of 980 diseased joints were detected in 720 patients with lumbar facet joint degeneration,of which 893 were detected by MRI and 905 were detected by CT.There were no significant differences in diagnostic sensitivity,positive predictive value and accuracy between the two methods.The detection rate of joint vacuum sign,articular surface hyperplasia,articular dislocation,calcification of ligamentum flavoid,articular surface flatness,facet bone and articular process fracture in MRI was significantly lower than that in CT,while the detection rate of subarticular cartilage degeneration was significantly higher than that in CT,the difference was statistically significant(P<0.05).Conclusion There is no difference in the diagnostic value of CT and MRI for lumbar facet joint degeneration,CT is suitable for the diagnosis of hard tissue lesions,while MRI is suitable for the diagnosis of soft tissue lesions,therefore,both can be combined for the diagnosis of patients with lumbar facet joint degeneration in clinical practice to improve the detection rate of patients with different lesions.

关 键 词：腰椎 小关节退变 计算机断层扫描 磁共振 影像学 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]