MSCT、MRI对脊柱侧弯矫正手术的指导价值

The guiding value of MSCT and MRI in correction operations of scoliosis

目的:探究多层螺旋CT(MSCT)、磁共振成像(MRI)对脊柱侧弯的诊断价值及两种诊断技术对脊柱侧弯矫正手术的指导价值。方法:选取63例脊柱侧弯患者作为研究对象,所有患者均接受MSCT、X线平片及MRI检查,比较MSCT与X线平片检查对脊柱侧弯的检出情况,分析MSCT、MRI对患者椎体的显示情况;另收集经MSCT指导(MSCT组32例)及经MRI指导(MRI组28例)进行矫正手术患者的临床资料,比较两组术后的Cobb角、后凸角及矫正率的差异。结果:63例患者中经X线平片检出脊柱侧弯78处,经MSCT检出脊柱侧弯131处,X线平片、MSCT对脊柱侧弯检出率的差异有统计学意义(P<0.05);MSCT对顶椎(100.00%vs 17.46%)、脊柱全貌(100.00%vs 36.51%)的显现率显著高于MRI(P<0.05),而对脊髓异常的显现率(36.51%vs 77.78%)显著低于MRI(P<0.05)。MSCT组术后的Cobb角及后凸角小于MRI组(P<0.05),术后矫正率高于MRI组(P<0.05)。结论:在脊柱侧弯检查与诊断中,MSCT对异常椎体的检出能力明显优于传统X线平片,MRI则侧重于对椎管内病变的精准显示,MSCT对病椎位置关系显露更佳,更有利于指导脊柱侧弯矫正手术。

Objective:To explore the diagnostie value of multi-slice spiral CT(MSCT)and magnetic resonance imaging(MRI)on scoliosis,and analyze the guiding value of the two techniques on corrective surgery for scoliosis.Methods:A total of 63 patients with scoliosis treated in the hospital were selected as the research subjects.All patients received MSCT examination,X-ray plain film examination and MRI examination.The detection status of scoliosis by MSCT and X-ray plain film examination were compared,and the display status of vertebral body were analyzed by MSCT and MRI.The clinical data of patients undergoing corrective surgery guided by MSCT(MSCT group,32 cases)and MRI(MRI group,28 cases)were also collected,and the differences in postoperative Cobb angle,postoperative kyphosis angle and correction rate were compared between the two groups.Results:Among 63 patients,78 scolioses were detected by X-ray plain film and 131 scolioses were detected by MSCT.The difference in detection rate of scoliosis by X-ray plain film and MSCT was statistically significant(P<0.05).The display rates of apical vertebra and spine overview of MSCT were significantly higher than those of MRI(100.00%vs 17.46%,100.00%vs 36.51%)(P<0.05)while the display rate of spinal cord abnormality was significantly lower than that of MRI(36.51%vs 77.78%)(P<0.05).The postoperative Cobb angle and kyphosis angle in MSCT group were smaller than those in MRI group(P<0.05),and the correction rate was higher than that in MRI group(P<0.05).Conclusion:In the examination and diagnosis of scoliosis,MSCT has better detection ability of abnormal vertebral bodies than traditional X-ray plain film examination,but MRI focuses on the accurate display of intraspinal lesions,and MSCT can better reveal the position of the affected vertebrae and is more beneficial to guiding the corrective surgery of scoliosis.