基于MRI的伪CT图像对骶髂关节炎结构性病变的诊断效能

Diagnostic Efficacy of Pseudo-CT Images based on MRI for Structural Lesions of Sacroiliitis

目的 分析基于MRI的伪CT图像对骶髂关节炎结构性病变的诊断效能。方法 选择2020年7月至2021年6月于本院放射科检查的疑似骶髂关节炎患者53例,分别采用CT、T;加权MRI及伪CT对结构性病变进行诊断,并以CT结果为参考标准,比较MRI及伪CT对结构性病变的诊断效能。结果 除MRI诊断侵蚀的观察者间一致性强度为中等水平外(K=0.593),CT、伪CT及MRI诊断结构性病变的观察者内一致性、观察者间一致性绝大部分处于较强水平(k=0.627~0.898);采用广义估计方程调整参与者内部相关效应后,伪CT诊断侵蚀的准确性及特异性明显高于MRI,诊断硬化、强直的准确性及敏感性明显高于MRI,差异有统计学意义(P<0.05);伪CT诊断侵蚀、强直的置信度明显优于MRI(P<0.05);伪CT诊断结构性病变与CT比较差异无统计学意义(P>0.05)。结论 在疑似骶髂关节炎结构性病变诊断中,采用基于MRI的伪CT图像比T;加权MRI的诊断效能更高,置信度可与CT媲美。

Objective To analyze the diagnostic efficacy of pseudo-CT images based on MRI for structural lesions of sacroiliitis. Methods 53 patients with suspected sacroiliitis who were examined in the radiology department of our hospital from July 2020 to June 2021 were selected. CT, T;-weighted MRI and pseudo-CT were used to diagnose structural lesions, and the CT results were used as references.Standard to compare the diagnostic efficacy of MRI and pseudo-CT for structural lesions. Results In addition to the moderate intensity of inter-observer consistency in MRI diagnosis of erosions(k=0.593),the intra-observer and inter-observer consistency of CT, pseudo-CT and MRI in the diagnosis of structural lesions were mostly at a strong level(K=0.627~0.898). After using the generalized estimation equation to adjust the internal correlation effects of participants, the accuracy and specificity of pseudo-CT in diagnosing erosion were significantly higher than that of MRI, and the accuracy and sensitivity of diagnosing sclerosis and rigidity were significantly higher than that of MRI, and the difference was statistically significant(P<0.05). The confidence of pseudo-CT in the diagnosis of erosion and rigidity is significantly better than that of MRI(P<0.05). There is no difference between pseudo-CT in the diagnosis of structural lesions and CT Statistically significant(P>0.05). Conclusion In the diagnosis of structural lesions of suspected sacroiliitis, MRI-based pseudo-CT images have higher diagnostic efficiency than T;-weighted MRI, and the confidence level is comparable to CT.