影像科学与光化学2026，Vol.44Issue(4)：55-60,6.DOI:10.7517/issn.1674-0475.2026.04.09
CT、MRI在胸腰椎骨折后方韧带复合体损伤诊断中的效能及影像特点观察
Efficacy and Imaging Features of CT and MRI in the Diagnosis of Posterior Ligamentous Complex Injury in Thoracolumbar Fracture
摘要
Abstract
Objective:To observe the efficacy and imaging features of CT and MRI in the diagnosis of posterior ligamentous complex(PLC)injury in thoracolumbar fracture.Methods:A total of 106 patients with thoracolumbar fracture who were diagnosed and treated at Mianyang Orthopedic Hospital from June 2021 to June 2024 were selected.All patients underwent CT and MRI examinations before surgery.With surgical results as the gold standard,the diagnostic efficacy of CT,MRI,and combination of the two for PLC injury in thoracolumbar fracture was analyzed.Kappa consistency test was used to evaluate the consistency between the diagnostic results of CT,MRI and combination of the two for PLC injury in thoracolumbar fracture and surgical results.The image characteristics were observed and a comparative analysis with non-PLC injury was conducted.Results:Surgical results showed that among 106 patients with thoracolumbar fractures,50 had PLC Injury and 56 had no PLC Injury.Compared with surgical results,the sensitivity,specificity,accuracy,positive and negative predictive values of CT for diagnosing PLC injury in thoracolumbar fracture were 74.00％,85.71％,80.19％,82.22％and 78.69％,respectively(Kappa=0.600).The sensitivity,specificity,accuracy,positive and negative predictive values of MRI for diagnosing PLC injury in thoracolumbar fracture were 80.00％,89.29％,84.91％,86.96％and 83.33％,respectively(Kappa=0.696).The sensitivity,specificity,accuracy,positive and negative predictive values of CT combined with MRI for diagnosing PLC injury in thoracolumbar fracture were 96.00％,98.21％,97.17％,97.96％and 96.49％,respectively(Kappa=0.943).The sensitivity,specificity,accuracy,positive and negative predictive values of CT combined with MRI were higher than those of CT or MRI(P＜0.05).CT examination revealed that the incidences of avulsion fractures of the spinous process,transverse fractures of the facet joint,widened spinous process space,fracture rotation,dislocation and angulation in patients with PLC injury were 36.00％,24.00％,30.00％,16.00％,40.00％and 12.00％respectively,which were higher than those in patients without PLC injury(P＜0.05).MRI examination revealed that the incidences of high signal or continuity interruption on T2WI,ligament thickening,ligament shortening with uneven signal,blurred paraspinal muscle space,and epidural hematoma in patients with PLC injury were 38.00％,20.00％,10.00％,42.00％,and 16.00％respectively,which were higher than those in patients without PLC injury(P＜0.05).Conclusion:CT combined with MRI can improve the diagnostic efficacy of PLC injury in thoracolumbar fractures and provide reliable information for clinical diagnosis and treatment.However,the gold standard of this study is based only on the intraoperative observations,and the methodological design needs to be further improved in the future.关键词
胸腰椎骨折/后方韧带复合体损伤/CT/MRI/诊断效能/影像特点Key words
thoracolumbar fracture/posterior ligamentous complex injury/CT/MRI/diagnostic efficacy/imaging features分类
医药卫生引用本文复制引用
黄樱长,王富春,刘纯,卜发平,胡伟..CT、MRI在胸腰椎骨折后方韧带复合体损伤诊断中的效能及影像特点观察[J].影像科学与光化学,2026,44(4):55-60,6.基金项目
四川省卫生健康委员会科研项目(17PJ207). （17PJ207）
