MSCT扫描及MPR矢状位重建图像技术在胸腰椎压缩骨折患者影像学诊断的应用

Application of MSCT Scanning and MPR Sagittal Reconstructed Image Technique in Imaging Diagnosis of Thoracolumbar Vertebral Compression Fractures

目的探讨多层螺旋CT(MSCT)扫描及MPR矢状位重建图像技术在胸腰椎压缩骨折患者影像学诊断的应用价值。方法选取我院收治的胸腰椎压缩骨折患者96例为研究对象,均行X线、MSCT检查,比较两种方法诊断胸腰椎压缩骨折的灵敏度、特异度、准确度,并分析椎体骨折分布情况及不同类型胸腰椎压缩骨折的显示率,观察胸腰椎压缩骨折的MSCT影像特征。结果 96例患者骨折椎体114例,范围为T12-L5椎体,其中以T12-L1椎体最多(75.44%);MSCT诊断胸腰椎骨折的灵敏度75.00%、准确度73.96%明显高于X线检查60.00%、64.58%(P<0.05),特异度比较无显著差异(P>0.05);MPR重建中矢状位对胸腰椎压缩骨折的显示率90.91%较冠状位69.42%、横断面64.46%高(P<0.05);MPR矢状位重建图像显示骨折整体,立体感强,能很好地显示椎管变形、椎管内碎骨片。结论 MSCT扫描及MPR矢状位重建图像技术对胸腰椎压缩骨折具有重要的诊断价值,值得在临床推广应用。

Objective To explore the application value of multi-slice spiral CT （MSCT） scanning and MPR sagittal reconstructed image technique in the imaging diagnosis of thoracolumbar vertebral compression fractures. Method, 96 patients with ttloracolumbar vertebral compression fractures in our hospital were selected as the study subjects. All subjects underwent X-ray and MSCT examination. The sensitivity, specificity and accuracy in the diagnosis ofthoracolumbar vertebral compression fractures were compared between the two methods. The distribution of vertebral fractures and display rates of different types of thoracolumbar vertebral compression fractures were analyzed, and the MSCT findings of thoracolumbar vertebral compression fractures were observed. Results In 96 cases, there were 114 fractured vertebral bodies, and the range was T12-LS, of which T12-L1 was the most （75.44%）. The sensitivity and accuracy of MSCT in the diagnosis of thoracolumbar fractures （75.00%, 73.96%） were significantly higher than those of X-ray （60.00%, 64.58%） （P〈0.05） but there was no significant difference in specificity between the two diagnostic methods （P〉0.05）. The display rate of sagittal position in MPR reconstruction for thoracolnmbar vertebral compression fractures （90.91%） was higher than coronal position （69.42%） and transverse section （64.46%） （P〈0.05）. MPP, sagittal reconstructed images showed the overall fractures, and the three-dimensional sense was strong. It could well display spinal deformation and broken bone tablets in vertebral canal. Conclusion MSCT scan and MPR. sagittal reconstructed image technique are of important value in diagnosis ofthoracolumbar vertebral compression fiactures.