探讨股骨头坏死患者CT与核磁共振的临床诊断价值

Study on Clinical Diagnosis Value of CT and Nuclear Magnetic Resonance for Patients with Caput Femoris Necrosis

目的探讨对股骨头坏死患者应用CT与核磁共振(MRI)检查的临床诊断价值。方法回顾性分析2015年3月—2016年9月间该院接诊的146例股骨头坏死患者的临床诊断资料,按接诊时的顺序将患者分为观察A组和观察B组,两组各73例,在性别、年龄、股骨头坏死的病程与病症等方面差异无统计学意义(P>0.05)。观察A组的73例患者均采用CT扫描检查,观察B组的73例患者均采用MRI检查。临床对比分析两种不同检查方式的影像学表现及其股骨头坏死的检出率结果。结果这146例疑似股骨头患者通过分组采用不同的检测方法,发现观察A组的73例患者在经MRI检查后确诊为股骨头坏死者共计70例,检出率为95.89%(70/73);且对70(n=73)例进行分期诊断,其中31例Ⅰ期、16(n=19)例Ⅱ期、Ⅲ期11例、Ⅳ期12例。观察B组的73例患者在经CT检查后确诊为股骨头坏死者共计54例,检出率为73.97%(54/73);且对54(n=73)例进行分期诊断,其中21(n=31)例Ⅰ期、15(n=19)例Ⅱ期、Ⅲ期9(n=11)例、Ⅳ期8(n=12)例。对比可知,应用MRI的检出率明显高于CT(P<0.05),且对各分期诊断的准确程度也高(P<0.05),对比差异有统计学意义(P<0.05)。结论通过上述两种不同检查方式诊断后,可发现,临床对股骨头坏死患者的诊断过程中,应用核磁共振检查的检出率要比CT扫描的检出率高,更有利于早期确诊,且检出效果更满意,对股骨头坏死患者具有更高的临床诊断价值。

Objective To discuss the clinical diagnosis value of CT and nuclear magnetic resonance for patients with caput femoris necrosis.Methods 146 cases of patients with caput femoris necrosis diagnosed in our hospital from March 2015 to September 2016 were selected and divided into two groups with 73 cases in each according to the admission order,and the differences in the gender,age,caput femoris necrosis course and symptom between the two groups had no statistical significance（P〈0.05）,and the observation A group adopted the CT scanning examination,the observation B group adopted the MRI examination,and the imaging performance and test rate of caput femoris necrosis of the two examination methods were compared.Results In the observation A group,there were 70 cases diagnosed with caput femoris necrosis after MRI examination,and the test rate was 95.89%（70/73）,and these patients were diagnosed by stages,which showed 31 cases duringⅠ stage,16 cases during Ⅱ stage,11 cases during Ⅲ stage and 12 cases during Ⅳ stage,and in the observation B group,there were 54 cases diagnosed with caput femoris necrosis after CT examination and the test rate was 73.97%（54/73）,and these patients were diagnosed by stages,which showed 21 cases during Ⅰ stage,15 cases during Ⅱ stage,9 cases duringⅢ stage and 8 cases during Ⅳ stage,and the test rate of MRI and diagnostic accurate degree of various stages were obviously higher than those of CT（P〈0.05）,and the differences had statistical significance by comparison（P〈0.05）.Conclusion The diagnosis shows that the test rate of nuclear magnetic resonance for patients with caput femoris necrosis is higher than that of CT scanning,which is more conducive to the early diagnosis with higher test effect and higher clinical diagnosis value for patients with caput femoris necrosis.