数字化断层融合技术在脊柱结核诊断中的临床价值

Clinical Value of Digital Tomosynthesis Applied in the Diagnosis of Spinal Tuberculosis

目的探讨X线数字体层融合技术(DTS)在脊柱结核检查中的价值。方法回顾性分析经手术病理证实的44例脊柱结核患者的临床及数字化摄影(DR)和DTS图像,由2名放射科副主任医师分别阅片,评价每张图像的质量,明确骨质破坏、死骨形成和椎旁脓肿的检出情况,比较脊柱正侧位X线平片和脊柱正侧位DTS的图像质量及对椎体骨质破坏、死骨形成和椎旁脓肿的检出率。结果脊柱正侧位DTS图像的良好率高于X线平片(χ2=7.605,P=0.006);脊柱正侧位DTS对椎体骨质破坏、死骨形成和椎旁脓肿的检出率均高于X线平片(χ2=6.439,11.636,6.545;P=0.026,0.001,0.011)。结论 DTS对脊柱结核的影像诊断具有图像清晰、病变检出率高的优势,值得推广应用。

Objective To investigate the clinical value of digital tomosynthesis applied in the diagnosis of spinal tuberculosis. Methods Forty four patients with spinal tuberculosis,confirmed by surgical pathology,were retrospectively analyzed. The images of DR and DTS were read by two associate chief physicians. The ratio of excellent images and the detection rates of bone destruction,sequestrum formation and paraspinal abscess were compared between the spine lateral digital radiology and digital tomosynthesis. Results The ratio of excellent images was 86. 09%（ 37 /44） for digital radiology,and 100. 00% for digital tomosynthesis. The difference was significant（ χ2= 7. 605,P = 0. 006）. The detection rates of bone destruction,sequestrum formation and paraspinal abscess were 86. 36%,31. 82% and 36. 36%,respectively for digital radiology,and 100. 00% 、68. 18% and 63. 64% for digital tomosynthesis. The differences were significant（ χ2=6. 439,11. 636,6. 545; P = 0. 026,0. 001,0. 011）. Conclusion Digital tomosynthesis had higher image quality and detection rates of lesion compared with digital radiology. Therefore,it is worth being widely applied in the diagnosis of spinal tuberculosis.