椎体压缩性骨折的数字X射线摄影诊断的应用价值分析

Application value analysis of digital radiography diagnosis of vertebral compression fracture

目的探讨椎体压缩性骨折的数字X射线摄影诊断(DR)的应用价值。方法选取2019年1月至2020年3月于本院就诊的86例疑似椎体压缩性骨折患者作为研究对象,比较X线及DR诊断的诊断符合率、灵敏度、特异度,分析不同诊断方法的椎体压缩性骨折影像学特征。结果以MRI、手术为金标准,DR诊断灵敏度、诊断符合率均高于X线诊断,差异有统计学意义(P<0.05);两种诊断方法特异度比较差异无统计学意义。X线诊断影像显示,椎体楔形变;前缘骨皮质嵌压,其后部高度无变化;椎体前方出现分离骨碎片、椎间隙正常;部分患者出现椎体错位,伴棘突、横突骨折。DR诊断影像显示,椎体前缘、前侧缘部位出现“双边特征”或不规则骨折线;椎体后壁无损伤,侧面呈楔形征,可见骨皮质断裂、塌陷、不连、不光整;受累部位椎体皮质下松质骨致密;椎体前上角变性或塌陷;椎体前上部骨小梁出现紊乱、模糊。结论椎体压缩性骨折应用DR诊断方式准确率较高,其图像清晰、方便快捷、分辨率较高,具有较高的应用价值,在实际临床工作中可联合运用其他影像手段,提高对椎体压缩性骨折的诊断准确性。

Objective To explore the application value of digital radiography(DR)for vertebral compression fractures.Methods 86 patients with suspected vertebral compression fractures treated in our hospital from January 2019 to March 2020 were selected as the study subjects,and the diagnostic coincidence rate,sensitivity and specificity of the X-ray and DR diagnosis were compared were compared,and the imaging characteristics of vertebral compression fractures with different diagnostic methods were analyzed.Results With MRI and surgery as the gold criteria,DR diagnostic sensitivity and diagnostic coincidence rate were higher than X-ray diagnosis,the difference was statistically significant(P<0.05).There was no significant difference in the specificity of the two diagnostic methods.X-ray diagnosis revealed a wedge-shaped vertebral body;the anterior cortex was impinged,and the posterior height did not change;Separated bone fragments appeared in front of the vertebral body,and the vertebral space was normal;some patients had vertebral dislocation with spinous process and transverse process fractures.DR diagnosis showed that there were"bilateral features"or irregular fracture lines at the anterior and lateral edges of the vertebral body;the posterior wall of the vertebral body was not damaged,the side was wedge-shaped,and the cortical fracture,collapse,disunion,and disunity were visible;the subcortical cancellous bone of the affected vertebra is dense;degeneration or collapse of anterior upper vertebral angle;the anterior upper trabecular bone of the vertebral body was disordered and blurred.Conclusion The DR diagnostic method for vertebral compression fractures has high accuracy,and its images are clear,convenient,fast,and high resolution,which has high application value,in actual clinical work,it can be combined with other imaging methods to improve the diagnostic accuracy of vertebral compression fractures.