SPECT-CT、MRI诊断骨质疏松性椎体压缩性骨折疼痛责任椎体的准确性比较

Comparison of Accuracy of SPECT-CT and MRI in Diagnosing the Painful Responsible Vertebral Bodies of Osteoporotic Vertebral Compression Fractures

目的观察单光子发射计算机断层摄影术-同机CT扫描图像融合技术(SPECT-CT)、磁共振成像(MRI)在诊断骨质疏松性椎体压缩性骨折(OVCF)疼痛责任椎体中的应用价值。方法回顾性分析44例(106个椎体)OVCF患者的临床资料,患者均接受SPECT-CT、MRI检查确认疼痛责任椎体,进行手术治疗,于术前、术后3d时评估患者疼痛程度[视觉模拟评分(VAS)],比较SPECT-CT、MRI诊断OVCF患者疼痛责任椎体准确性差异。结果患者术后3d时VAS评分显著低于术前(P<0.05)。SPECT-CT、MRI诊断急性期与非急性期OVCF患者椎体骨折个数关联性均有统计学意义(P<0.05),优势性无统计学意义(P>0.05);2种方法对急性期与非急性期患者诊断Kappa值分别为0.938、0.720。结论SPECT-CT与MRI均可准确确认OVCF疼痛责任椎体,二者具有良好的关联性和较高的一致性,对无法接受MRI检查的患者,SPECT-CT是一种可靠诊断方式。

Objective To observe the application value of single photon emission computed tomography scan image fusion technique(SPECT-CT)and magnetic resonance imaging(MRI)in the diagnosis of painful responsible vertebral bodies of osteoporotic vertebral compression fracture(OVCF).Methods The clinical data of 44 OVCF patients(106 vertebral bodies)were analyzed retrospectively.All patients were given SPECT-CT and MRI to confirm the painful responsible vertebral bodies,and the patients were treated with surgery.The pain level[visual analogue scale(VAS)]was evaluated before surgery and at 3 days after surgery,and the accuracy was compared between SPECT-CT and MRI in the diagnosis of painful responsible vertebral bodies of OVCF patients.Results The VAS score at 3 day after surgery was significantly lower than that before surgery(P<0.05).There was a statistically significant difference in the correlation between SPECT-CT and MRI in the diagnosis of vertebral fractures quantity in acute and non-acute OVCF patients(P<0.05),and there was no statistically significant difference in the dominance(P>0.05).The Kappa values of the two methods for acute phase or nonacute patients were 0.938 and 0.720 respectively.Conclusions both SPECT-CT and MRI can accurately confirm the painful responsible vertebral bodies of OVCF,and the two have good correlation and high consistency.SPECT-CT is a reliable diagnosis method for patients who cannot undergo MRI.