股骨头坏死患者应用CT与MRI检查的临床价值分析

Clinical value analysis of CT and MRI in patients with necrosis of the femoral head

目的探讨电子计算机断层扫描(computed tomography,CT)与核磁共振成像(magnetic resonance imaging,MRI)检查在股骨头坏死患者临床诊断中的价值。方法选择2019年10月至2021年3月福建省龙岩市第二医院诊治的62例疑似股骨头坏死患者作为研究对象,均接受CT、MRI影像学检查及随访手术病理结果,比较手术病理诊断结果与CT、MRI的检出结果,评估CT与MRI检测真阳性率、真阴性率、正确指数和Kappa值。结果MRI检测对骨小梁结构模糊征象、骨髓水肿、线样征典型征象的阳性检出率均高于CT检出率,差异有统计学意义(P<0.05),而MRI、CT对单一囊变阳性检出率,差异无统计学意义(χ^(2)=0.170,P>0.05);MRI检测真阳性率(94.5%)高于CT检测真阳性率(81.7%),χ^(2)=7.142,P<0.05,Kappa=0.127;MRI检测真阴性率(97.0%)高于CT检测真阴性率(75.8%)[χ^(2)=6.304,P<0.05,Kappa=0.212];MRI检测正确指数(0.915)也高于CT组(0.593)。结论股骨头坏死的MRI、CT影像检测表现出一定的特征性,结合临床表现,有助于股骨头坏死患者的诊断,其中早期患者的MRI检测技术更为灵敏,有利于及早开展针对性治疗。

Objective To explore the value of CT and MRI in the clinical diagnosis of patients with femoral head necrosis.Methods From October 2019 to March 2021,62 patients with suspected femoral head necrosis treated in the Second Hospital in Fujian Province Longyan City,hospital were studied.All study patients received dual-source CT and MRI imaging examinations and follow-up surgical and pathological results.The surgical pathological diagnosis results of 62 patients were compared with the detection results of dual-source CT and MRI,and the true positive rate,true negative rate,correct index and Kappa value of CT and MRI were evaluated.Results The positive detection rate of MRI for fuzzy signs of trabecular structure,bone marrow edema and typical linear signs was higher than that of CT,with a statistically significant difference(P<0.05),while the positive detection rate of MRI and CT for single cystic change was not statistically significant(χ^(2)=0.170,P>0.05);the true positive rate of MRI detection(94.5%)was higher than the true positive rate of dual-source CT detection(81.7%),χ^(2)=7.142,P<0.05,Kappa value=0.127;the true negative rate of MRI detection(97.0%)was higher than the true negative rate of dual-source CT detection(75.8%)[χ^(2)=6.304,P<0.05,Kappa=0.212];MRI detection accuracy index(0.915)was also higher than that of dual-source CT group(0.593).Conclusion MRI and CT image detection of femoral head necrosis show certain characteristics.Combined with clinical manifestations,it is helpful for the diagnosis of patients with femoral head necrosis.Among them,MRI detection technology in early stage patients is more sensitive,which is conducive to early targeted treatment.