磁共振成像与CT检查在腰椎间盘突出症诊断中的效能比较

Comparison of efficiencies of magnetic resonance imaging and CT examination in diagnosis of lumbar disc herniation

目的:比较磁共振成像(MRI)与CT检查在腰椎间盘突出症(LDH)诊断中的效能。方法:选取2018年9月至2020年8月该院收治的86例疑似LDH患者为研究对象,所有患者均进行MRI、CT检查,以术后病理检查结果为金标准,比较MRI与CT检查在LDH诊断中的效能及对不同病变部位、病变程度、LDH征象的检出率。结果:86例疑似LDH患者中,病理检查结果显示阳性74例,阴性12例;其中L_(2~3)9例,L_(3~4)27例,L_(4~5)26例,L_(5~S1)12例;Ⅰ度8例,Ⅱ度26例,Ⅲ度29例,Ⅳ度11例;硬膜囊受压39例,椎间盘变形24例,椎间盘钙化34例,神经根受压27例。MRI检查诊断LDH的灵敏度、准确度均高于CT检查,漏诊率低于CT检查,差异有统计学意义(P<0.05)。MRI检查对L_(3~4)病变的检出率高于CT检查,差异有统计学意义(P<0.05)。MRI检查对Ⅱ度病变的检出率高于CT检查,差异有统计学意义(P<0.05)。MRI检查对硬膜囊受压、椎间盘变形征象的检出率均高于CT检查,对椎间盘钙化征象的检出率低于CT检查,差异有统计学意义(P<0.05)。结论:MRI检查在腰椎间盘突出症诊断中的效能高于CT检查。

Objective:To compare efficiencies of magnetic resonance imaging(MRI)and CT examination in diagnosis of lumbar disc herniation(LDH).Methods:86 patients with suspected LDH admitted to this hospital from September 2018 to August 2020 were selected as the research objects.All patients underwent MRI and CT examination.Using the results of postoperative pathological examination as the gold standard,the efficiencies of MRI and CT in the diagnosis of LDH and the detection rates of different lesion sites,lesion degrees and LDH signs were compared.Results:Among the 86 patients with suspected LDH,74 cases were confirmed as positive and 12 cases were negative by the pathological examination.There were 9 cases of L_(2-3),27 cases of L_(3-4),26 cases of L_(4-5)and 12 cases of L_(5-S1).There were 8 cases of I degree,26 cases of II degree,29 cases of III degree and 11 cases of IV degree.There were 39 cases of dural sac compression,24 cases of intervertebral disc deformation,34 cases of intervertebral disc calcification,and 27 cases of nerve root compression.The sensitivity and accuracy of MRI in the diagnosis of LDH were higher than those of CT,the missed diagnosis rate was lower than that of CT,and the differences were statistically significant(P<0.05).The detection rate of L_(3-4)by MRI was higher than that by CT,and the difference was statistically significant(P<0.05).The detection rate of II degree by MRI was higher than that by CT,and the difference was statistically significant(P<0.05).Further,the detection rates of dural sac compression and intervertebral disc deformation signs by MRI were higher than those by CT,the detection rate of intervertebral disc calcification signs by MRI was lower than that by CT,and the differences were statistically significant(P<0.05).Conclusions:The efficiency of MRI in the diagnosis of lumbar disc herniation is higher than that of CT.