不同影像学检查方法诊断布氏杆菌性脊柱炎的对比研究.docVIP

不同影像学检查方法诊断布氏杆菌性脊柱炎的对比研究 　　【摘要】 目的：探讨DR、CT三维重建、MRI三种影像学方法在布氏杆菌性脊柱炎诊断中的意义。方法：回顾性总结2010-2013年在宁夏医科大学总医院就诊治疗的33例布氏杆菌性脊柱炎患者的资料，以病理检查和实验室检查结果为诊断标准，比较DR、CT三维重建和MRI检查在布氏杆菌性脊柱炎诊断中的作用。结果：在椎间隙变化的显示方面DR占优势；CT三维重建对椎体骨破坏、死骨、硬化骨形成以及韧带变化等方面有较高的显示率；MRI主要是对椎间盘破坏、椎旁脓肿形成、骨膜改变及肉芽肿形成等方面优于DR和CT三维重建；前两者者联合能提高布氏杆菌性脊柱炎各征象的显示率；三者联合则能够对该病做出全面准确诊断。在诊断符合率方面，DR对布氏杆菌性脊柱炎诊断的符合率为54.5%，CT三维重建为90.9%，MRI为93.9%，前两者联合诊断布氏杆菌性脊柱炎的符合率为97.0%。而三者联合检查应用的诊断符合率达100%。经统计学分析，DR与CT三维重建、DR与MRI检查的诊断准确率差异有统计学意义（P0.05），DR、CT三维重建联合检查与三者联合检查相比差异无统计学意义（P0.05），联合检查与单独检查相比差异有统计学意义（P0.05）。结论：联合应用DR、CT三维重建、MRI是全面准确显示布氏杆菌性脊柱炎病理征象的有效方法。DR、CT三维重建、MRI联合检查诊断布氏杆菌性脊柱炎能达到极好的效果。 　　【关键词】 布氏杆菌性脊柱炎； DR； CT三维重建； MRI 　　【Abstract】 Objective：To study the value of DR，CT-3D reconstruction and MRI in the dignosis of the brucellosis spondylitis.Method：Thirty three patients with brucellosis spondylitis treated in General Hospital of Ningxia Medical University from 2010 to 2013 were randomly selected in this study.Diagnosis of all the patients were confirmed by means of surgery，pathological and laboratory examinations.The effect of DR，CT-3D reconstruction and MRI were compared in the dignosis of the brucellosis spondylitis.Result：DR was in the dominant place to display changes in the intervertebral space，CT-3D reconstruction was a high displacement in the vertebral bone destruction，sequestrum，sclerotic bone and changes of ligaments，MRI was better than DR and CT-3D reconstruction mainly on the disc destruction， paraspinal abscess ， aspects of periosteal changes and granuloma formation.The combination of before two could improve the display rate of various signs in brucellosis spondylitis.The combination of all three was able to make a comprehensive and accurate diagnosis of the disease.In the diagnosis rate，DR was 54.5% in the diagnosis of brucellosis spondylitis compliance，CT-3D reconstruction was 90.9%，MRI was 93.9%.The combination of before two was 97.0 % in the diagnosis of brucellosis spondylitis.The combination of all three was 100 %.