多层螺旋CT联合动态对比增强磁共振成像在脊柱结核患者诊断中的价值

Value of Multi-slice Spiral CT Combined with Dynamic Contrast-enhanced Magnetic Resonance Imaging in the Diagnosis of Spinal Tuberculosis Patients

目的探究多层螺旋CT(MSCT)联合动态对比增强磁共振成像(DCE-MRI)在脊柱结核患者诊断中的价值。方法选取2020年1月-2022年3月吉安市吉水县人民医院收治的74例疑似脊柱结核患者为研究对象,按照随机数字表法分为对照组(37例)与观察组(37例)。对照组行MSCT检查,观察组应用MSCT联合DCE-MRI检查,比较两种检测方案的敏感度、特异度、准确度,分析其与病理诊断结果的一致性及两组病理特征的检出率。结果MSCT联合DCE-MRI诊断脊柱结核的敏感度、特异度、准确度高于MSCT检测(P<0.05);MSCT诊断与病理学诊断具有中等一致性(κ=0.520),MSCT联合DCE-MRI诊断与病理学诊断具有较好一致性(κ=0.904);观察组椎体破坏、椎间隙改变、椎间盘改变、椎旁脓肿、骨质破坏、硬膜囊受压特征的检出率高于对照组(P<0.05),但两组死骨形成、软组织钙化的检出率比较,差异无统计学意义(P>0.05)。结论MSCT联合DCE-MRI对脊柱结核具有较高诊断价值,其敏感度、特异度、准确度均较为理想,与病理结果具有较好一致性,可有效检出脊柱结核患者的病理特征。

Objective To explore the value of multi-slice spiral CT(MSCT)combined with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of spinal tuberculosis.Methods A total of 74 patients with suspected spinal tuberculosis admitted to Jishui County People's Hospital of Ji'an City from January 2020 to March 2022 were selected as the research objects,and they were divided into control group(37 patients)and observation group(37 patients)according to random number table method.The control group was examined by MSCT,and the observation group was examined by MSCT combined with DCE-MRI.The sensitivity,specificity and accuracy of the two detection schemes were compared,and the consistency with pathological diagnosis results and the detection rate of pathological features of the two groups were analyzed.Results The sensitivity,specificity and accuracy of MSCT combined with DCE-MRI in the diagnosis of spinal tuberculosis were higher than those of MSCT(P<0.05).MSCT diagnosis and pathological diagnosis had moderate consistency(κ=0.520),and MSCT combined with DCE-MRI diagnosis and pathological diagnosis had good consistency(κ=0.904).The detection rates of vertebral body destruction,intervertebral space change,intervertebral disc change,paravertebral abscess,bone destruction and dural sac compression in the observation group were higher than those in the control group(P<0.05),but there was no significant difference in the detection rates of sequestrum formation and soft tissue calcification between the two groups(P>0.05).Conclusion MSCT combined with DCE-MRI has high diagnostic value for spinal tuberculosis.Its sensitivity,specificity and accuracy are ideal.It has good consistency with pathological results and can effectively detect the pathological features of patients with spinal tuberculosis.