磁共振扩散成像和CT在脊椎骨折病因诊断中价值的比较

Comparison of the Diagnostic Value of MR Diffusion Imaging and CT in Vertebral Fracture

目的:比较磁共振扩散加权成像(Diffusion-weighted imaging,DWI)和CT在脊椎骨折诊断中价值。方法:选取我院2020年4月-2021年4月就诊的脊椎骨折患者192例纳入本次研究,根据骨折类型将其分为单纯性骨折(92例)和病理性骨折(100例),所有患者均接受DWI、CT诊断,对比DWI和CT诊断脊椎骨折的准确性。结果:(1)192例脊椎骨折患者中:单纯性脊椎骨折92例,共计骨折椎体156个。病理性脊椎骨折患者100例,共计骨折椎体196个。(2)在单纯性脊椎骨折诊断方面:DWI骨折椎体检出率为97.44%,高于CT诊断的87.18%,组间差异无统计学意义(X^(2)=0.624,P=0.453);在病理性脊椎骨折诊断方面:DWI脊椎转移瘤检出率为98.08%,高于CT检出的82.69%,DWI多发性骨髓瘤检出率为100.00%,高于CT检出的83.33%,DWI结核检出率为95.37%,高于CT检出的74.07%。DWI病理性脊椎骨折检出率为96.94%,高于CT检出的78.06%,组间差异有统计学意义(X^(2)=4.625,P=0.001)。(3)病理性脊椎骨折ADC值为(1.63±0.22)×10^(3)mm^(2)/s,低于单纯性脊椎骨折的(2.44±0.24)×10^(3)mm^(2)/s,组间差异有统计学意义(t=18.365,P=0.000)。结论:DWI在病理性脊椎骨折诊断准确率方面明显优于CT诊断,但在外伤引起的单纯性骨折诊断差异不大,临床应根据患者具体实际科学选择。

Objective:Compare the value of diffusion weighted imaging(DWI)and CT in the diagnosis of spinal fractures.Meth-ods:A total of 192 patients with vertebral fracture in our hospital were selected for inclusion in this study(Inclusion time:April 2020 April 2021).According to the fracture type,they were divided into simple fracture(92 cases)and pathological fracture(100 cases).All patients were diagnosed by DWI and CT.The accuracy of DWI and CT in diagnosing vertebral fracture was compared.Results:(1)Among 192 cases of vertebral fracture,92 cases were simple vertebral fracture,with 156 vertebral bodies in total.There were 100 patients with pathological vertebral fractures,with 196 vertebral fractures in total.(2)In the diagnosis of simple vertebral fracture,the physical examination rate of DWI fracture was 97.44%higher than that of CT diagnosis(87.18%),and there was no significant difference between the groups(X^(2)=0.624,P=0.453>0.05);In the diagnosis of pathological spinal fractures,the detection rate of spinal metastases on DWI was 98.08%,higher than that of CT(82.69%),the detection rate of multiple myeloma on DWI was 100.00%,high-er than that of CT(83.33%),and the detection rate of tuberculosis on DWI was 95.37%,higher than that of CT(95.37%),The de-tection rate of pathological vertebral fracture on DWI was 96.94%,which was higher than that of CT 78.06%.There was significant difference between the groups(X^(2)=4.625,P=0.001).(3)ADC value of pathological vertebral fracture(1.63±0.22)×10^(3)mm^(2)/s is lower than that of simple spinal fracture(2.44±0.24)×10^(3)mm^(2)/s,the difference between groups was statistically significant(t=18.365,P=0.000)Conclusion:DWI is significantly better than CT in the diagnosis of pathological vertebral fracture,but there is lttle difference in the diagnosis of simple fracture caused by trauma.Clinical selection should be based on the actual situation of patients.