CT三维重建及薄层扫描联合磁共振ADC定量诊断良、恶性脊柱骨折的价值分析OA
Value Analysis of CT 3D Reconstruction and Thin Slice Scanning Combined with Magnetic Resonance ADC in Quantitative Diagnosis of Benign and Malignant Spinal Fractures
目的:探讨CT三维重建及薄层扫描联合磁共振ADC定量诊断良、恶性脊柱骨折的价值.方法:选取该院2021年 2月—2023年 2月收治的 80例脊柱骨折患者为研究对象,所有患者均使用CT三维重建及薄层扫描、磁共振表观扩散系数定量诊断,并且以病理诊断作为金标准,对比 3种诊断方式的诊断价值、诊断效能、影像学特征及ADC数值.结果:经病理诊断 80例脊柱骨折患者中良性52例,恶性 28例.CT三维重建及薄层扫描、磁共振表观扩散系数定量诊断、联合检查良性检出数分别为 41例、47例、51例,其中联合检查阳性检出数更高,与病理检查结果具有一致性,差异有统计学意义(P<0.05).联合检查阳性检出率、灵敏度、特异度、阳性预测值、阴性预测值、诊断符合率均高于磁共振表观扩散系数定量诊断、CT三维重建及薄层扫描,组间差异有统计学意义(P<0.05).CT影像特征显示,良性脊柱骨折患者有 80.77%呈现T 2WI高信号,恶性脊柱骨折 89.29%存在T 2WI高信号,差异无统计学意义(P>0.05).良性椎体骨折椎体形态楔形为90.30%,高于恶性脊柱骨折的 64.29%,恶性脊柱骨折椎体后缘膨隆概率为42.86%,高于良性的 7.69%,恶性脊柱骨折椎旁软组织结节肿块检出为32.14%,良性脊柱骨折未检出结节肿块;良性脊柱骨折ADC均值为(2.14±0.70)×10-3 mm2/s,恶性脊柱骨折ADC均值为(1.24±0.41)×10-3 mm2/s,组间差异有统计学意义(P<0.05).结论:脊柱骨折患者疾病诊断过程中使用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能够实现疾病的良性恶性区分,对于疾病治疗方案制订有重要指导价值.
Objective:To investigate the value of CT 3D reconstruction and thin slice scanning combined with magnetic resonance ADC in the quantitative diagnosis of benign and malignant spinal fractures.Methods:80 patients with spinal fractures admitted to our hospital from February 2021 to February 2023 were selected as the study objects.All patients were quantitatively diagnosed by three-dimensional CT reconstruction,thin-layer scanning and magnetic resonance apparent diffusion coefficient,and pathological diagnosis was taken as the gold standard.The diagnostic value,diagnostic efficiency,imaging features and ADC values of the three diagnostic methods were compared.Results:Among the 80 patients with spinal fracture,52 cases were benign and 28 cases were malignant.CT 3D reconstruction,thin layer scanning,magnetic resonance apparent diffusion coefficient quantitative diagnosis and combined examination benign detection were 41 cases,47 cases and 51 cases,respectively,among which the combined examination benign detection data were higher,consistent with the results of pathological examination,the difference was statistically significant(P<0.05).The positive detection rate,sensitivity,specificity,positive predictive value,negative predictive value and diagnostic coincidence rate of combined examination were higher than those of quantitative diagnosis of magnetic resonance apparent diffusion coefficient,CT three-dimensional reconstruction and thin layer scanning,and the differences between groups were statistically significant(P<0.05).CT imaging features showed that 80.77%of patients with benign spinal fractures showed high T2WI signal,while 89.29%of patients with malignant spinal fractures showed high T2WI signal,with no statistical significance(P>0.05).The vertebral shape of benign vertebral fractures was 90.30%,higher than that of malignant vertebral fractures(64.29%);the posterior margin of vertebral bulge was 42.86%,higher than that of benign spinal fractures(7.69%);paravertebral soft tissue nodules were detected in malignant vertebral fractures(32.14%),and no nodules were detected in benign spinal fractures.The mean ADC values of benign spine fractures were(2.14±0.70)×10-3 mm2/s,and those of malignant spine fractures were(1.24±0.41)×10-3 mm2/s,and the difference between groups was statistically significant(P<0.05).Conclusion:The quantitative diagnosis of the apparent diffusion coefficient of magnetic resonance combined with CT three-dimensional reconstruction and thin layer scanning can distinguish the benign and malignant diseases in the diagnosis of spinal fracture patients,which has important guiding value for the formulation of disease treatment plan.
张婧婷
内蒙古自治区人民医院,内蒙古 呼和浩特 010010
临床医学
脊柱骨折CT三维重建薄层扫描磁共振ADC
Spinal fractureCT 3D reconstructionThin layer scanningMagnetic resonance ADC
《中国伤残医学》 2024 (009)
17-20 / 4
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