DWI联合血清CA125,TNF-α,IL-23在鉴别良恶性椎体骨折中的价值  

VALUE OF DWI COMBINED WITH SERUM CA125,TNF-A,IL-23 IN DIFERENTIATING BENIGN AND MALIGNANT VERTEBRAL FRACTURES

作　　者：占传家 王君芳[2] ZHAN Chuanjia;WANG Junfang(Honghu Traditional Chinese Medicine Hospital,Honghu 433200,China)

机构地区：[1]湖北省洪湖市中医医院,433200 [2]黄石市中心医院(湖北理工学院附属医院)

出　　处：《中国煤炭工业医学杂志》2023年第3期316-320,共5页Chinese Journal of Coal Industry Medicine

基　　金：湖北省卫生健康委联合基金项目(编号:WJ2019H459)。

摘　　要：目的探讨弥散加权成像(DWI)联合糖类抗原125(CA125)、肿瘤坏死因子α(TNF-α)、白细胞介素-23(IL-23)在良恶性椎体骨折中的诊断价值。方法选取2017年1月—2020年7月在该院治疗的脊柱椎体压缩性骨折患者103例145椎体,其中骨折疏松性脊柱椎体压缩性骨折62例89椎体(良性组),骨转移瘤型脊柱椎体压缩性骨折41例56椎体(恶性组),均给予MRI常规及DWI序列扫描,同时检测血清CA125,TNF-α,IL-23水平。结果恶性组椎体后边缘膨隆、T1WI低信号和T2WI高信号比例分别为58.93%、91.07%和87.50%,明显高于良性组(P<0.05);二组椎体楔形比例比较差异无统计学意义(P>0.05);恶性组椎体表观扩散系数(ADC)值为(0.92±0.23)×10^(-3)mm^(2)/s,明显低于良性组椎体(P<0.05);恶性组血清CA125、TNF-α、IL-23分别为(44.49±13.35)U/L、(20.02±8.92)pg/ml和(70.39±21.10)pg/ml,明显高于良性组(P<0.05);ADC值联合血清CA125,TNF-α,IL-23诊断恶性椎体骨折的ROC曲线下面积为0.922,P<0.05,明显高于其他指标(P<0.05),灵敏性和特异性分别为94.50%和88.40%。结论DWI序列ADC值联合血清CA125、TNF-α、IL-23诊断良恶性椎体骨折有较好的价值,值得临床使用。Objective To investigate the diagnostic value of diffusion weighted imaging(DWI)combined with carbohydrate antigen 125(CA125),tumor necrosis factorα(TNF-α),interleukin-23(IL-23)in benign and malignan vertebral fractures.Methods One hundred and three patients(145 vertebrae)with vertebral compression fractures treated in our hospital from January 2017 to July 2020 were selected,among them,62 cases of osteoporotic vertebral compression fractures(89 vertebrae)(benign group),41 cases(56 vertebrae)of bone metastasis type vertebral compression fractures(malignant group)were selected,all patients were given routine MRI and DWI sequence scanning,and serum CA125,TNF-α,IL-23 levels were detected.Results In malignant group,the ratio of posterior margin bulge,T1WI low signal and T2WI high signal were 58.93%,91.07%and 87.50%,respectively,which were significantly higher than those in benign group(P<0.05);There was no significant difference in vertebral wedge proportion between benign and malignant group(P>0.05);The apparent diffusion coefficient(ADC)value of malignant group was(0.92±0.23)X10^(-3)mm^(2)/s,which was significantly lower than that of benign group(P<0.05);The serum CA125,TNF-αand IL-23 in malignant group were(44.49±13.35)U/L,(20.02±8.92)pg/ml and(70.39±21.10)pg/ml,whichwere significantly higher than those in benign group(P<0.05);The area under ROC curve of ADC value combined with serum CA125,TNF-αand IL-23 in the diagnosis of malignant vertebral fractures was 0.922,P<0.05,which was significantly higher than other indicators(P<0.05),the sensitivity and specificity were 94.50%and 88.40%respectively.Conclusion The ADC value of DWI sequence combined with serum CA125,TNF-αand IL-23 has good value in the diagnosis of benign and malignant vertebral fractures,which isworthyofclinical application.

关 键 词：弥散加权成像 糖类抗原125 肿瘤坏死因子α 白细胞介素-23 良性 恶性 椎体骨折 

分 类 号：R61[医药卫生—外科学]