颈椎病患者使用X线平片和CT影像诊断的临床诊断效果分析

Analysis of Clinical Diagnosis Effect of Patients with Cervical Spondylosis Using Plain X-ray and CT Imaging

目的分析在颈椎病临床诊断中应用X线平片和CT影像诊断的临床价值及效果。方法选取该院在2017年6月—2020年12月收治的68例门诊颈椎疼痛疑似颈椎病患者为研究对象,所有患者均实施X线平片和CT影像检查,并以MRI诊断结果为金标准,分析两种检查方案的检查结果,对比其诊断效能,评估两种诊断形式对颈椎病病症表现诊断结果、特异性征象检出率及影像学特征表现。结果该次纳入68例疑似颈椎病患者中,金标准诊断为颈椎病(阳性)45例、非颈椎病(阴性)23例;X线平片诊断阳性43例、阴性25例;CT影像检查诊断阳性44例、阴性24例。CT影像检查的灵敏度、特异度、阳性预测值、阴性预测值及诊断符合率分别为93.33%、91.30%、95.45%、87.50%、92.65%,均高于X线平片的77.78%、65.22%、81.40%、60.00%、73.53%,差异有统计学意义(P<0.05);CT影像检查在钩突增生、颈椎曲度异常、椎体后缘骨赘方面检出率分别为84.44%、51.11%、46.67%,均高于X线平片的60.00%、26.67%、24.44%,差异有统计学意义(P<0.05);CT影像检出率为42.22%,明显高于X线平片的20.00%,差异有统计学意义(P<0.05);X线检查下多呈双边征,可见椎间孔狭窄,CT诊断则可见椎体小关节处存在关节突骨赘,同时伴有后纵韧带钙化、椎间盘突出表现。结论在颈椎病临床诊断中,对于诊断效能,CT影像检查优于X线平片;但在病症征象表现以及特异性征象检出情况方面对比可见,X线平片与CT影像检查方案各具优势,其均能够在一定程度上为疾病的诊断及后续治疗提供参考,故在颈椎病患者临床诊断中,建议以CT影像检查为主,同时辅助X线平片检出,以便更好地进行病情评估,提升诊断准确率,为疾病的后续诊疗提供科学参考。

Objective To analyze the clinical value and effect of X-ray plain film and CT imaging in the clinical diagnosis of cervical spondylosis.Methods A total of 68 outpatient patients with cervical spine pain and suspected cervical spondylopathy who were admitted to the hospital from June 2017 to December 2020 were selected as the research objects.All patients underwent X-ray plain film and CT imaging examination,and the MRI diagnosis result was the gold standard.Analyzed the inspection results of the two inspection programs,compared their diagnostic performance,and evaluated the diagnostic results,specific signs detection rate and imaging characteristics of the two diagnostic methods for cervical spondylosis.Results Among 68 patients with suspected cervical spondylosis,45 cases were diagnosed as cervical spondylosis(positive)and 23 cases were non-cervical spondylopathy(negative)diagnosed by the gold standard.X-ray plain film diagnosis was positive in 43 cases and negative in 25 cases.CT imaging diagnosis was positive in 44 cases and negative in 24 cases.The sensitivity,specificity,positive predictive value,negative predictive value,and diagnostic coincidence rate of CT imaging were 93.33%,91.30%,95.45%,87.50%,92.65%,which were higher than those of plain X-ray films 77.78%,65.22%,81.40%,60.00%,73.53%,the difference was statistically significant(P<0.05).The detection rates of uncinate hyperplasia,abnormal cervical curvature,and osteophytes on the posterior edge of the vertebral body were respectively 84.44%,51.11%,46.67%in CT imaging examination,which were higher than those of 60.00%,26.67%,24.44%in plain radiographs,the difference was statistically significant(P<0.05).The detection rate of CT images was 42.22%,which was significantly higher than 20.00%of plain X-ray films,the difference was statistically significant(P<0.05).X-ray examination usually showed bilateral signs,and intervertebral foramina stenosis.CT diagnosis showed the presence of articular osteophytes at the facet joints of the vertebral body,accompanied by posterior longitudinal ligament calcification and intervertebral disc herniation.Conclusion In the clinical diagnosis of cervical spondylosis,CT imaging examination is better than plain X-ray film for the diagnostic efficiency.However,the comparison of symptoms and detection of specific signs shows that plain X-ray and CT imaging have their own advantages,and both can provide reference for the diagnosis and subsequent treatment of the disease to a certain extent.Therefore,in the clinical diagnosis of patients with cervical spondylosis,it is recommended that CT imaging examination be the mainstay,and X-ray plain film detection is assisted at the same time,to better evaluate the condition,improve the accuracy of diagnosis,and provide scientific reference for the follow-up diagnosis and treatment of the disease.