多层螺旋CT与磁共振成像对股骨头坏死的临床诊断价值比较分析

Comparison of Clinical Diagnostic Value of Multi-slice Spiral CT and Magnetic Resonance Imaging in Femoral Head Necrosis

目的 探讨多层螺旋CT(multislice spiral CT,MSCT)与磁共振成像(magnetic resonance imaging,MRI)对股骨头坏死的临床诊断价值。方法 选取2020年10月—2023年10月济宁市兖州区人民医院收治的78例疑似股骨头坏死患者为研究对象,入院后均行MSCT、MRI检查,以临床综合诊断为金标准,比较两种不同检查方法对股骨头坏死的诊断效能及诊断符合率。结果 78例疑似股骨头患者中,临床综合诊断阳性76例,阴性2例;MSCT诊断阳性66例,阴性12例;MRI诊断阳性76例,阴性2例。MRI对股骨头坏死诊断的灵敏度为97.37%、准确度为94.87%,高于MSCT的85.53%、84.62%,差异有统计学意义(χ^(2)=8.291、4.332,P均<0.05)。MRI对股骨头坏死不同分期诊断符合率高于MSCT,差异有统计学意义(P均<0.05)。MRI对股骨头坏死线样征、骨小梁模糊、局部囊性变以及骨髓水肿诊断符合率分别为89.74%、76.92%、73.21%、79.59%,均高于MSCT的60.00%、51.28%、41.07%、30.61%,差异有统计学意义(χ^(2)=24.818、11.143、11.813、23.758,P均<0.05)。结论 与MSCT相比,MRI对股骨头坏死诊断效能更高,且可进一步观察股骨头坏死实际情况,为疾病早期诊治提供可靠依据。

Objective To investigate the clinical value of multislice spiral CT(MSCT) and magnetic resonance imaging(MRI) in the diagnosis of femoral head necrosis.Methods Seventy-eight patients with suspected femoral head necrosis admitted to Yanzhou District People's Hospital of Jiling City from October 2020 to October 2023 were selected as the study objects.MSCT and MRI examinations were performed after admission.Comprehensive clinical diagnosis was used as the gold standard to compare the diagnostic efficacy and diagnostic coincidence rate of two different examination methods for femoral head necrosis.Results Of the 78 suspected femoral head patients,76 were positive and 2 were negative.There were 66 positive cases and 12 negaative cases diagnosed by MSCT.Three were 76 positive cases and 2 negative cases diagnosed by MRI.The sensitivity and accuracy of MRI for the diagnosis of femoral head necrosis were 97.37% and 94.87% higher than those of MSCT(85.53% and 84.62%),and the differences were statistically significant(χ^(2)=8.291,4.332,both P<0.05).The coincidence rates of MRI for different stages of femoral head necrosis was higher than that of MSCT,and the differences were statistically significant(all P<0.05).The diagnostic coincidence rates of MRI for linear necrosis of femoral head,trabecular blur,local cystic change and bone marrow edema were 89.74%,76.92%,73.21%and 79.59%,respectively,which were higher than 60.00%,51.28%,41.07% and 30.61% of MSCT,the differences were statistically significant(χ^(2)=24.818,11.143,11.813,23.758,all P<0.05).Conclusion Compared with MSCT,MRI is more effective in the diagnosis of femoral head necrosis,and can further observe the actual situation of femoral head necrosis,providing a reliable basis for early diagnosis and treatment of the disease.