摘要
目的 对比多层螺旋计算机体层摄影(CT)、数字X线摄影(DR)与磁共振(MR)对腰椎小关节疾病的诊断准确度.方法 选取我院2022年1月至2023年12月收治的127例腰腿疼痛高度疑似腰椎小关节疾病的患者作为研究对象,对所有患者进行多层螺旋CT、DR与MR诊断,以临床综合诊断作为"金标准",对比3种不同方式对腰椎小关节疾病的诊断结果,分析其影像学特征,最后建立受试者工作特征(ROC)曲线分析多层螺旋CT、DR与MR对腰椎小关节疾病的诊断效能.结果 多层螺旋CT、DR与MR对不同关节病损诊断情况对比差异有统计学意义(P＜0.05),MR关于关节面下骨质囊变、关节囊肿胀、滑膜囊肿、软骨退变、关节间隙变窄诊断率较高,多层螺旋CT关于关节面增生、关节囊钙化、关节脱位、关节间隙真空诊断率较高;127例患者通过临床综合诊断确诊为腰椎小关节疾病者共90例,多层螺旋CT、DR、MR及联合诊断确诊例数分别为62例、54例、78例及86例;不同诊断方式对腰椎小关节疾病诊断灵敏度、特异度、准确率从高到低分别为联合诊断(95.6％、97.3％、86.1％)、MR(86.7％、81.1％、85.0％)、多层螺旋 CT(68.6％、67.6％、68.5％)、DR(60.0％、48.6％、56.7％).结论 多层螺旋CT、DR与MR对于腰椎小关节疾病均具有重要诊断参考价值,虽然MR诊断准确度高于多层螺旋CT、DR,但依然存在漏诊与误诊情况,临床可考虑将三者结合诊断腰椎小关节病变,进一步提升诊断准确率.
Abstract
Objective To compare the diagnostic accuracy of multi-slice spiral computed tomography(MSCT),digital radiography(DR),and magnetic resonance(MR)in the diagnosis of lumbar facet joint diseases.Methods 127 patients with high suspicion of lumbar facet joint disease and low back and leg pain admitted to our hospital from Jan-uary 2022 to December 2023 were selected as the research subjects.Multi slice spiral CT,DR,and MR diagnosis were performed on all patients,and clinical comprehensive diagnosis was used as the"gold standard".The diagnostic results of three different methods for lumbar facet joint disease were compared,and their imaging characteristics were analyzed.Finally,the diagnostic efficacy of MSCT,DR,and MR for lumbar facet joint disease was analyzed.Results There was a statistically significant difference in the diagnosis of different joint lesions between MSCT,DR,and MR(P＜0.05).MR had a higher diagnostic rate for subcortical bone cystic changes,joint cyst swelling,synovial cysts,cartilage degenera-tion,and joint space narrowing,while MSCT had a higher diagnostic rate for joint surface hyperplasia,joint cyst calcifi-cation,joint dislocation,and joint space vacuum;Out of 127 patients,a total of 90 were diagnosed with lumbar facet joint disease through clinical comprehensive diagnosis.The number of confirmed cases by MSCT,DR,MR,and com-bined diagnosis were 62,54,78,and 86,respectively;The sensitivity,specificity,and accuracy of different diagnostic methods for lumbar facet joint diseases are as follows:combined diagnosis(95.6％,97.3％,86.1％),MR(86.7％,81.1％,85.0％),multi-slice spiral CT(68.6％,67.6％,68.5％),and DR(60.0％,48.6％,56.7％).Conclusion MSCT,DR,and MR have important diagnostic reference value for lumbar facet joint diseases.Although MR has higher diagnostic accuracy than MSCT and DR,there are still cases of missed diagnosis and misdiagnosis.Clinically,the combination of the three can be considered to diagnose lumbar facet joint diseases and further improve diagnostic accuracy.
维普
万方数据