CT引导下与X线引导下的髋关节穿刺对髋关节假体周围感染术前的诊断价值  

Comparison of Accuracy of Computed Tomography-Guided and Fluoroscopic-Guided Joint Aspiration in Preoperation Diagnosis of Hip Joint Periprosthetic Infection

作　　者：艾尼瓦尔江·达毛拉 麦迪娜·迪力夏提 窦海伟 哈巴西·卡肯[1] Ainiwaerjiang·Damaola;Maidina Dilixiati;DOU Haiwei(Joint Surgery Department,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi Xinjiang)

机构地区：[1]新疆维吾尔自治区人民医院骨科中心关节老年病区,新疆乌鲁木齐830001

出　　处：《医学临床研究》2024年第9期1312-1314,1318,共4页Journal of Clinical Research

基　　金：新疆维吾尔自治区人民医院院内基金项目(编号:20200112)。

摘　　要：【目的】探讨CT引导下的髋关节穿刺与X线引导下的髋关节穿刺对髋关节假体周围感染(periprosthetic joint infection,PJI)术前的诊断价值。【方法】选取2018年6月至2022年5月在本院就诊且疑似髋关节PJI的90例患者,随机分为X线穿刺组(X线引导下的髋关节穿刺,n=44)和CT穿刺组(CT引导下的髋关节穿刺,n=46),两组在翻修术前分别在X线引导下、CT引导下进行髋关节穿刺,采集的穿刺液进行细菌培养,并与翻修术中获得标本的细菌培养结果(金标准)对照,比较两组灵敏性、特异性、阳性预测值、阴性预测值、95%置信区间、准确性及受试者工作特征(ROC)曲线下面积。【结果】CT穿刺组灵敏度、特异度、准确度、ROC曲线下面积分别为94.1%、85.7%、93.4%、0.919,与X线穿刺组的62.5%、93.1%、77.2%、0.723比较,差异均有统计学意义(P<0.05)。【结论】对于疑似髋关节PJI的病例,CT引导下的髋关节穿刺对髋关节PJI的术前诊断价值优于X线引导下的髋关节穿刺。【Objective】The aim of this prospectively randomized study was to compare the sensitivity,specificity,and accuracy of CT-guided hip aspiration and fluoroscopic-guided hip aspiration in the preoperative diagnosis of periprosthetic joint infection(PJI).【Methods】Ninety patients who were suspected of hip PJI in our hospital from June 2018 to May 2022 were randomly received fluoroscopic-guided(n=44)or CT-guided(n=46)hip aspiration before revision surgery.The results of culture tests of joint fluid operation and during-surgery(which was considered as golden standard)were compared.The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and area under the ROC curve of the two groups were calculated respectively.【Results】The sensitivity,specificity,accuracy and area under the ROC curve of the CT puncture group were 94.1%,85.7%,93.4%and 0.919,respectively,which were significantly different from those of the X-ray puncture group(62.5%,93.1%,77.2%and 0.723,respectively).The differences were statistically significant(P<0.05).【Conclusion】For suspected hip PJI,preoperative CT-guided aspiration seems to be an effective selection for early diagnosis of PJI.In addition,CT-guided aspiration showed a better sensitivity,specificity and accuracy than fluoroscopic-guided aspiration.

关 键 词：髋假体 感染/诊断 体层摄影术 螺旋计算机 X线 关节穿刺术 

分 类 号：R687.42[医药卫生—骨科学]