CT与MRI检查在腰椎间盘突出诊断中的应用效果分析

Application of CT and MRI in the diagnosis of lumbar disc herniation

目的:分析计算机断层扫描(CT)及磁共振成像(MRI)用于腰椎间盘突出症诊断中的临床价值。方法:选取2020年1月-2023年1月菏泽市第三人民医院收治的90例疑似腰椎间盘突出症患者,均应用CT、MRI检查,以临床医生综合判断及手术结果为金标准,统计CT与MRI诊断结果,比较两种检查方法诊断效能,分析不同影像征象检出情况。结果:临床医生综合判断及手术结果显示,90例疑似腰椎间盘突出患者中阳性50例,阴性40例。CT检查阳性48例,阴性42例;MRI检查阳性49例,阴性41例;CT、MRI诊断结果与金标准具有高度一致性,Kappa值分别为0.843、0.869。CT与MRI诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值均较高,MRI略高于CT,差异无统计学意义(P> 0.05);50例腰椎间盘突出症的患者各类征象诊断中,MRI对脊髓变性检出率明显高于CT(P <0.05),MRI神经根受压检出率高于CT,钙化、椎间盘积气方面检出率低于CT检查,但差异不显著(P> 0.05)。结论:对于腰椎间盘突出症,CT与MRI检查均具有良好的诊断价值,两种影像学方法对于腰椎间盘突出症发生后的不同征象诊断准确性存在差异,MRI对于脊髓变性和神经根受压的诊断效果更好,而CT在钙化和椎间盘积气方面的诊断效果更好,临床可根据实际情况选择应用。

Objective To analyze the clinical value of computed tomography(CT)and magnetic resonance imaging(MRI)in the diagnosis of lumbar disc herniation.Methods A total of 90 patients with suspected lumbar disc herniation admitted to the Third People's Hospital of Heze from January 2020 to January 2023 were selected for CT and MRI.With the clinician's comprehensive judgment and surgical results as the gold standard,the diagnostic results of CT and MRI were counted,the diagnostic efficiency of the two examination methods were compared,and the detection of different image signs were analyzed.Results Clinician's comprehensive judgment and surgical results showed that 90 suspected lumbar disc herniation patients,positive 50 cases,negative 40 cases.CT was positive in 48 cases and negative in 42 cases.MRI was positive in 49 cases and negative in 41 cases.CT and MRI diagnostic results highly consistent with the gold standard,with Kappa values of 0.843 and 0.869,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CT and MRI were higher,with MRI slightly higher than CT,and the difference was not statistically significant(P>0.05).Among the 50 patients with lumbar disc herniation,the detection rate of spinal cord degeneration in MRI was significantly higher than that in CT(P<0.05),the detection rate of nerve root compression in MRI was higher than that in CT,and the detection rate of calcification and intervertebral disc gas accumulation was lower than that in CT,but the difference was not significant(P>0.05).Conclusion Both CT and MRI have good diagnostic value for lumbar disc herniation,and the diagnostic accuracy of the two imaging methods for different signs after lumbar disc herniation is different.MRI has better diagnostic effect on spinal cord degeneration and nerve root compression,while CT has better diagnostic effect on calcification and disc gas accumulation.Clinical application can be selected according to the actual situation.