多层螺旋CT、MRI及二者联合对新鲜与陈旧性腰椎压缩性骨折的鉴别诊断价值OA
Differential Diagnosis Value of Multi-Slice Spiral CT,MRI and Their Combi-nation for Fresh and Old Lumbar Compression Fractures
目的 对比分析多层螺旋CT、MRI及二者联合对新鲜与陈旧性腰椎压缩性骨折的鉴别诊断价值.方法 选取 2022 年10 月至 2024 年 10 月期间开封市中心医院收治的 116 例腰椎压缩性骨折患者作为研究对象,共 148 个椎体,依据骨折时间将入选患者分为陈旧骨折组(定义为骨折时间＞7 d,55 例)和新鲜骨折组(定义为骨折时间≤7 d,61 例).所有患者均接受多层螺旋CT和MRI检查,对比新鲜与陈旧性腰椎压缩性骨折的多层螺旋CT、MRI影像学特征差异,评估多层螺旋CT、MRI及二者联合鉴别诊断新鲜与陈旧性腰椎压缩性骨折的效能.结果 多层螺旋CT、MRI检查结果均显示:新鲜骨折组的脊椎旁软组织影、脊髓挫伤、骨折线清晰锐利及附件骨折占比均显著高于陈旧骨折组,而椎体滑脱、椎体骨小梁结构紊乱、椎间盘真空征占比均显著低于陈旧骨折组,差异均具有统计学意义(P＜0.05).多层螺旋CT联合MRI诊断新鲜与陈旧性腰椎压缩性骨折的准确率为97.97%,显著高于多层螺旋 CT(86.49%)或 MRI(87.16%)单独诊断;而误诊率为 2.03%,显著低于多层螺旋 CT(10.81%)或MRI(9.46%)单独诊断,差异均具有统计学意义(P＜0.05).结论 多层螺旋CT、MRI均能有效鉴别新鲜与陈旧性腰椎压缩性骨折,但多层螺旋CT联合MRI诊断新鲜与陈旧性腰椎压缩性骨折的准确率更高、误诊率更低.
Objective To compare and analyze the value of multi-slice spiral CT,MRI and their combination in the differential diagnosis of fresh and old lumbar compression fractures.Methods A total of 116 patients with lumbar compression fractures admitted to Kaifeng Central Hospital from October 2022 to October 2024 were selected as the research objects,with a total of 148 vertebrae.According to the fracture time,the selected patients were divided into the old fracture group(defined as fracture time＞7 d,55 cases)and the fresh fracture group(defined as fracture time≤7 d,61 cases).All patients underwent multi-slice spiral CT and MRI examinations.The difference of multi-slice spiral CT and MRI imaging features between fresh and old lumbar compression fractures was compared,and the efficacy of multi-slice spiral CT,MRI and their combination in the differential diagnosis of fresh and old lumbar compression fractures was evaluated.Results The results of both multi-slice spiral CT and MRI examinations showed that the proportions of paravertebral soft tissue shadow,spinal cord contusion,clear and sharp fracture line and accessory fracture in the fresh fracture group were significantly higher than those in the old fracture group,while the proportions of vertebral spondylolisthesis,vertebral trabecular structure disorder and intervertebral disc vacuum sign in the fresh fracture group were significantly lower than those in the old fracture group,with statistically significant difference(P<0.05).The accuracy of multi-slice spiral CT combined with MRI in diagnosing fresh and old lumbar compression fractures was 97.97%,significantly higher than that of multi-slice spiral CT(86.49%)or MRI(87.16%)alone.The misdiagnosis rate was 2.03%,significantly lower than that of multi-slice spiral CT(10.81%)or MRI(9.46%)alone,with statistically significant difference(P<0.05).Conclusions Both multi-slice spiral CT and MRI can effectively differentiate fresh and old lumbar compression fractures,but the combination of multi-slice spiral CT and MRI demonstrates higher diagnostic accuracy and lower misdiagnosis rate.
高娟娟;李立;商飞翔;张舜
开封市中心医院 医学影像科,河南 开封 475000开封市中心医院 医学影像科,河南 开封 475000开封市中心医院 医学影像科,河南 开封 475000商丘市第一人民医院 骨科,河南 商丘 476100
医药卫生
腰椎压缩性骨折多层螺旋CTMRI新鲜骨折陈旧性骨折
Lumbar compression fractureMulti-slice spiral CTMRIFresh fractureOld fracture
《临床医学工程》 2026 (2)
141-144,4
二〇二〇年河南省科技发展计划项目(项目编号:202102310458)
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