X线片与MRI联合应用对提高脊柱骨折的检出率与诊断准确性

Improvement of Relevance Ratio and Diagnostic Accuracy of Spinal Fracture by X-ray Plus MRI

目的与单独使用X线片检查脊柱骨折比较,探讨联合应用X线片与磁共振成像(magnetic resonance imaging,MRI)对脊柱骨折的诊断价值。方法选取2015-01/2017-01月在作者医院收治的脊柱骨折患者240例,并使用随机数表法,随机分为研究组和对照组,各组120例。对照组患者仅使用X线片进行诊断,研究组使用X线片联合MRI进行诊断,对两组患者的诊断结果进行分析。结果对照组良性脊柱骨折检出率为70.00%(84/120),恶性脊柱骨折检出率为4.20%(5/120);研究组良性脊柱骨折检出率为90.00%(108/120),恶性脊柱骨折检出率为38.33%(46/120)。与临床随访或者手术病理结果进行对照,研究组确诊率为98.33%,漏诊率为1.67%;对照组确诊率为83.33%,漏诊率为16.67%。研究组诊断准确率、敏感度、特异度分别为87.50%、93.33%、86.67%;对照组诊断准确率、敏感度、特异度分别为70.80%、60.00%、31.67%,两组诊断结果比较差异有统计学意义(P<0.05)。结论 X线片联合MRI能够提高对脊柱骨折患者良恶性脊柱骨折检出率和诊断准确性。

Objective To evaluate the diagnostic value of combination of X-ray film and magnetic resonance imaging （MRI） for spinal fractures, and compare with single X-ray film. Methods A total of 240 patients with spinal fractures were collected in authors＂ hospital from January 2015 to January 2011, and divided into study group and control group by random number table, 120 patients in each. The control group only used X-ray film for diagnosis, and the study group diagnosed by X-ray film combined with MRI. The diagnosis results of two groups were analyzed. Results In the control group, the detection rate of benign spinal fractures was 70. 00% （84/120）, and the detection rate of malignant spine frac- ture was 4. 20% （5/120）. The detection rate of benign spine fracture and malignant spinal fracture in the study group were 90. 00% （108/120）, 38.33% （46/120）, respectively. Compared with clinical follow-up or pathology results, the diagnosis rate of the study group was 98. 33%, and the missed diagnosis rate was 1.67%. The diagnosis rate and missed diagnosis rate of the control group respectively were 83. 33% and 16. 67%. The diagnostic accuracy, sensitivity and specificity of the study group and control group were 87. 50%, 93. 33%, 86. 67% and 70. 80%, 60.00%, 31.67%, respec- tively. There were significantly different between two groups （P〈0. 05）. Conclusion X-ray film combines with MRI can improve the detection rate and diagnostic accuracy of benign and malignant spinal fractures in patients with spine fractures.