CT与MRI在椎体压缩性骨折良恶性鉴别诊断中的价值分析  

Value Analysis of CT and MRI in Differential Diagnosis of Benign and Malignant Vertebral Compression Fractures

作　　者：段争奥 DUAN Zheng’ao(Department of Image Center,The Third People’s Hospital of Jinan,Jinan 250132,China)

机构地区：[1]山东省济南市第三人民医院影像中心,山东济南250132

出　　处：《中国伤残医学》2024年第18期94-97,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨计算机断层扫描(CT)与磁共振成像(MRI)在椎体压缩性骨折(VCFs)良恶性鉴别诊断中的价值。方法:选取2021年6月-2024年5月济南市第三人民医院收治的98例VCFs患者为研究对象,98例患者入院后均接受CT与MRI检查。将病理结果作为“金标准”,评估CT与MRI对于VCFs的鉴别诊断结果并比较诊断的特异度、敏感度、准确度。同时,比较良恶性VCFs患者的影像学特征(跳跃性受累、连续性受累、楔形、双凹形、后缘角状突起、后缘膨隆)。结果:病理诊断显示98例VCFs患者中恶性48例(48.98%),良性50例(51.02%),其中CT诊断恶性47例(47.96%),MRI诊断恶性48例(48.98%)。MRI对于VCFs患者良恶性鉴别诊断的特异度98.00%、敏感度97.92%、准确度97.96%均高于CT的82.35%、82.98%、82.65%,差异均有统计学意义(P<0.05)。受累椎体影像学特征中,恶性组跳跃性受累、后缘角状突起、后缘膨隆的发生率分别为62.82%、41.67%、19.23%,均高于良性组的36.36%、1.21%、1.21%,连续性受累的发生率为41.67%,低于良性组的71.52%,差异均有统计学意义(P<0.05)。恶性组楔形、双凹形的发生率为64.10%、10.26%,与良性组的61.82%、10.91%比较,差异均无统计学意义(P>0.05)。结论:VCFs良恶性患者的影像学特征具有差异性,且MRI对于VCFs良恶性的鉴别诊断价值较CT更高,可以为临床后续诊疗提供可靠的参考信息。Objective:To evaluate the value of computed tomography(CT)and magnetic resonance imaging(MRI)in the differential diagnosis of benign and malignant vertebral compression fractures(VCFs).Methods:A total of 98 VCFs patients admitted to the Third People’s Hospital of Jinan from June 2021 to May 2024 were selected as the study objects.All 98 patients received CT and MRI examinations after admission.Using pathological findings as the"gold standard",the differential diagnosis results of CT and MRI for VCFs were evaluated and the specificity,sensitivity and accuracy of diagnosis were compared.Meanwhile,the imaging features of benign and malignant VCFs patients were compared(Jumping involvement,continuous involvement,wedge-shaped,biconcave,posterior angular protrusion,posterior bulging).Results:Among the 98 VCFs patients,48 cases(48.98%)were malignant and 50 cases(51.02%)were benign,among which 47 cases(47.96%)were malignant by CT and 48 cases(48.98%)were malignant by MRI.The specificity,sensitivity and accuracy of MRI for differential diagnosis of benign and malignant VCFs patients were 98.00%,97.92%and 97.96%,higher than 82.35%,82.98%and 82.65%of CT,with statistical significance(P<0.05).In the imaging features of the affected vertebra,the incidence of jump involvement,posterior marginal angular prominences and posterior marginal swelling in the malignant group was 62.82%,41.67%and 19.23%respectively,which were higher than 36.36%,1.21%and 1.21%in the benign group,and the incidence of continuous involvement was 41.67%,which was lower than 71.52%in the benign group,the differences were statistically significant(P<0.05).The incidence of wedge shape and double concave shape was 64.10%and 10.26%in the malignant group,and there was no statistical significance compared with 61.82%and 10.91%in the benign group(P>0.05).Conclusion:The imaging features of benign and malignant VCFs patients are different,and MRI is more valuable than CT in differentiating benign and malignant VCFs,it can provide reliable reference information for

关 键 词：椎体压缩性骨折 良性 恶性 计算机断层扫描 磁共振成像 鉴别诊断 

分 类 号：R683[医药卫生—骨科学]