摘要
目的 探讨CT三维重建及薄层扫描联合磁共振表观扩散系数定量诊断良性和恶性脊柱骨折的价值。方法 选取85例脊柱骨折患者的临床资料进行回顾性分析,选取时间为2018年5月至2020年6月,经病理确诊为良性脊柱骨折共50例、恶性脊柱骨折共35例,且予以CT、磁共振检查,对比阳、阴性预测值,分析良恶性脊柱骨折的影像学特征,比较良恶性的ADC值,评估CT平扫、CT三维重建及薄层扫描、磁共振、两项联合诊断良恶性脊柱骨折的AUC值、敏感度、特异度及约登指数。结果 85例脊柱骨折患者经CT平扫后,阳性预测值73.47%,阴性预测值61.11%;经CT三维重建及薄层扫描后阳性预测值为81.63%,阴性预测值为72.22%。经磁共振检测后,阳性预测值为90.00%,阴性预测值85.71%;经两项联合检测后,阳性预测值96.00%,阴性预测值94.23%。CT影像学特征显示,良性脊柱骨折出现T2WI高信号共43例,椎体形态以楔形占比更多,椎体后缘以成角多见,椎旁软组织呈环形增厚样;恶性脊柱骨折出现T2WI高信号34例,椎体形态以楔形或倒楔形为主,椎体后缘呈膨隆,椎旁软组织呈结节肿块。良性组的ADC值高于恶性组(P<0.05)。ROC曲线分析显示,CT平扫、CT三维重建及薄层扫描、磁共振、两项联合诊断良恶性脊柱骨折的AUC值分别为(0.674/0.771/0.897/0.951,P<0.05);敏感度分别为72.00%、80.00%、90.00%、96.00%;特异度分别为62.90%、74.30%、85.70%、94.30%。结论 CT三维重建及薄层扫描联合磁共振表观扩散系数定量诊断,有利于提高良恶性脊柱骨折检出率及降低误诊率。
Objective To investigate the value of CT three-dimensional reconstruction and thin-slice scanning combined with the apparent diffusion coefficient of magnetic resonance in the quantitative diagnosis of benign and malignant spinal fractures. Methods The clinical data of 85 patients with spine fractures were selected for retrospective analysis. The selection time was from May 2018 to June 2020. A total of 50 cases of benign spine fractures and 35 cases of malignant spine fractures were pathologically diagnosed. CT and magnetic Resonance examination,comparing positive and negative predictive values,analyzing the imaging characteristics of benign and malignant spine fractures,comparing the ADC value of benign and malignant,evaluating CT plain scan,CT three-dimensional reconstruction and thin-slice scan,magnetic resonance,two combined diagnosis of benign and malignant spine The AUC value,sensitivity,specificity and Youden index of fracture. Results The positive predictive value of 85 patients with spinal fractures after CT plain scan was 73.47%,and the negative predictive value was 61.11%;the positive predictive value after CT three-dimensional reconstruction and thin-slice scan was 81.63%,and the negative predictive value was 72.22%. After the magnetic resonance test,the positive predictive value was 90.00%,and the negative predictive value was 85.71%;after the two combined tests,the positive predictive value was 96.00% and the negative predictive value was 94.23%.CT imaging features showed that there were 43 cases of benign spinal fractures with high signal on T2WI. The shape of the vertebral body was more wedge-shaped,the posterior edge of the vertebral body was more often angled,and the paravertebral soft tissue was ring-shaped thickened;malignant spinal fractures appeared. In 34 cases with high signal intensity on T2WI,the vertebral body was mainly wedge-shaped or inverted wedge-shaped,the posterior edge of the vertebral body was swollen,and the paravertebral soft tissues were nodular masses.The ADC value of the benign group was higher than that of the malignant group(P<0.05).ROC curve analysis showed that the AUC values of CT plain scan,CT threedimensional reconstruction,thin-slice scan,magnetic resonance,and two combined diagnosis of benign and malignant spinal fractures were(0.674/0.771/0.897/0.951,P<0.05);the sensitivity was respectively They are 72.00%,80.00%,90.00%,96.00%;the specificity is 62.90%,74.30%,85.70%,94.30%,respectiv ely. Conclusion CT three-dimensional reconstruction and thin-slice scanning combined with magnetic resonance apparent diffusion coefficient quantitative diagnosis is beneficial to increase the detection rate of benign and malignant spinal fractures and reduce the misdiagnosis rate.
作者
张庭庭
白曼莫
吉思璇
陈明玮
刘广保
ZHANG Ting-ting;BAI Man-mo;JI Si-xuan;CHEN Ming-wei;LIU Guang-bao(Medical imaging department,Sanya Hospital of traditional Chinese medicine,Sanya 572000,Hainan Province,China;Department of Orthopedics and Traumatology of Traditional Chinese Medicine,Sanya 572000,Hainan Province,China)
出处
《中国CT和MRI杂志》
2023年第2期161-163,共3页
Chinese Journal of CT and MRI
基金
海南省卫生计生行业科研项目(19A200142)。
关键词
CT
三维重建
薄层扫描
磁共振
良性
恶性
脊柱骨折
CT
Three-Dimensional Reconstruction
Thin-Slice Scan
Magnetic Resonance
Benign
Malignant
Spine Fracture
