MRI与^(18)F-FDG PET/CT在结核性脊柱炎诊断中的应用价值

Application values of MRI and ^(18)F-FDG PET/CT in diagnosis of tuberculous spondylitis

目的:探讨MRI和^(18)F-FDG PET/CT在结核性脊柱炎与非结核性脊柱炎鉴别诊断中的应用价值。方法:回顾性分析某院2015年1月至2019年1月的180例感染性脊柱炎患者的临床资料,其中结核性脊柱炎72例、非结核性脊柱炎108例(包括化脓性脊柱炎59例,布鲁杆菌性脊柱炎49例)。所有患者均行MRI和^(18)F-FDG PET/CT检查,以病理学检查为对照,分析并比较MRI、^(18)F-FDG PET/CT对结核性脊柱炎的鉴别诊断价值。采用SPSS 22.0统计学软件进行数据分析。结果:MRI检测出结核性脊柱炎75例,非结核性脊柱炎105例,与病理学综合诊断结果一致性较高(Kappa=0.782,P<0.05);^(18)F-FDG PET/CT检测出结核性脊柱炎74例,非结核性脊柱炎106例,与病理学综合诊断结果一致性极好(Kappa=0.931,P<0.05)。在诊断结核性脊柱炎的敏感度、特异度、准确度中,MRI分别为88.89%、89.81%、89.44%,^(18)F-FDG PET/CT分别为97.22%、96.30%、96.67%。^(18)F-FDG PET/CT诊断结核性脊柱炎的敏感度、特异度、准确度均明显高于MRI诊断。结论:MRI、^(18)F-FDG PET/CT对结核性脊柱炎均具有较高的诊断价值,其中^(18)F-FDG PET/CT对结核性脊柱炎的诊断价值更高,可为结核性脊柱炎及早做出正确诊断提供参考。

Objective To investigate the value of MRI and ^(18)F-FDG PET/CT in the differential diagnosis of tuberculous spondylitis versus non-tuberculous spondylitis.Methods The clinical data of 180 patients with infectious spondylitis,including 72 cases of tuberculous spondylitis and 108 cases of non-tuberculous spondylitis(invloving in 59 cases of septic spondylitis and 49 cases of brucellosis spondylitis)from January 2015 to January 2019 in a hospital were retrospectively analyzed.All the patients underwent MRI and ^(18)F-FDG PET/CT examinations to analyze and compare the differential diagnostic values of MRI and ^(18)F-FDG PET/CT for tuberculous spondylitis,using pathological examination as a control.SPSS 22.0 statistical software was used for data analysis.Results MRI detected 75 cases of tuberculous spondylitis and 105 cases of non-tuberculous spondylitis,which were in high agreement with the diagnosis of pathology(Kappa=0.782,P<0.05);^(18)F-FDG PET/CT found 74 cases of tuberculous spondylitis and 106 cases of non-tuberculous spondylitis,which were in excellent agreement with the diagnosis of pathology(Kappa=0.931,P<0.05).The sensitivity,specificity and accuracy in the diagnosis of tuberculous spondylitis was 88.89%,89.81%and 89.44%for MRI and 97.22%,96.30%and 96.67%for ^(18)F-FDG PET/CT respectively.^(18)F-FDG PET/CT gained advantages over MRI significantly than MRI in sensitivity,specificity and accuracy when used to diagnose tuberculous spondylitis.Conclusion MRI and ^(18)F-FDG PET/CT both behaved well in diagnosing tuberculous spondylitis,with ^(18)F-FDG PET/CT having a higher diagnostic value for tuberculous spondylitis and providing references for the early and correct diagnosis of TB spondylitis.