MR、CT检查对强直性脊柱炎髋关节病变的诊断价值比较

Comparison of Diagnostic Value of MR and CT Examinations in Ankylosing Spondylitis Hip Joint Lesions

目的比较核磁共振(magnetic resonance,MR)、电子计算机断层摄影(computer Tomography,CT)检查对强直性脊柱炎髋关节病变的诊断价值。方法以贵州省人民医院于2017年10月—2022年10月收治的95例强直性脊柱炎疑似髋关节病变患者作为研究对象,收集患者MR、CT检查的影像资料进行分析,并以临床综合诊断作为“金标准”比较两种检查方式的诊断效能,同时观察两种检查方式对髋关节病变征像的检出率。结果80例患者出院诊断为强直性脊柱炎髋关节病变。MR检查对强直性脊柱炎髋关节病变的诊断符合率、特异度、灵敏度、阴性预测值以及阳性预测值分别为96.84%、93.33%、97.50%、87.50%、98.73%,较CT检查的81.05%、60.00%、85.00%、42.86%、91.89%高,差异有统计学意义(χ^(2)=12.046、4.658、7.828、7.695、4.097,P<0.05),MR检查的误诊率、漏诊率分别为6.67%、2.50%,较CT检查的40.00%、15.00%低,差异有统计学意义(P<0.05)。MR检查对关节强直、关节面侵蚀、关节间隙狭窄、关节软组织肿胀、关节面下骨质囊变、关节面下骨质硬化的检出率分别为88.57%、88.24%、95.38%、94.87%、93.44%、93.75%,高于CT检查的64.29%、64.71%、81.54%、75.64%、75.41%、77.08%,差异有统计学意义(P<0.05)。结论MR检查可有效检出强直性脊柱炎髋关节病变,诊断效能高于CT检查,而且,该检查方式对病变征象的检出率较高,因此,可作为临床诊断该疾病的优选方案。

Objective To compare the diagnostic value of nuclear magnetic resonance(MR)and computerized tomography(CT)in ankylosing spondylitis hip joint lesions.Methods A total of 95 patients with ankylosing spondylitis suspected of hip joint lesions admitted to Guizhou Provincial People's Hospital from October 2017 to October 2022 were selected as the research objects.The imaging data of MR and CT examinations of patients were collected and analyzed,and the diagnostic efficacy of the two examination methods was compared using comprehensive clinical diagnosis as the"gold standard".At the same time,the detection rate of the two inspection methods on the signs of hip joint disease was observed.Results Eighty patients were discharged and diagnosed as ankylosing spondylitis hip joint lesions.The diagnostic coincidence rate,specificity,sensitivity,negative predictive value,and positive predictive value of MR examination for ankylosing spondylitis hip joint lesions were 96.84%,93.33%,97.50%,87.50%,and 98.73%,respectively,which were higher than those of CT examination 81.05%,60.00%,85.00%,42.86%,91.89%,the difference was statistically significant(χ^(2)=12.046,4.658,7.828,7.695,4.097,P<0.05),the misdiagnosis rate and missed diagnosis rate of MR examination were 6.67%and 2.50%,respectively,which were lower than those of CT examination(40.00%and 15.00%),the difference was statistically significant(P<0.05).The detection rates of MR examination for joint ankylosis,articular surface erosion,joint space narrowing,joint soft tissue swelling,subarticular bone cystic degeneration,and subarticular bone sclerosis were 88.57%,88.24%,95.38%,94.87%,93.44%,93.75%,higher than CT examination 64.29%,64.71%,81.54%,75.64%,75.41%,77.08%,the difference was statistically significant(P<0.05).Conclusion MR examination can effectively detect hip joint lesions in ankylosing spondylitis,with a higher diagnostic efficiency than CT examination.Moreover,this examination method has a higher detection rate of lesion signs,making it a preferred option for clinical diagnosis of the disease.