对抗生素治疗失败的MRI的预测性表现 发作性脊椎骨髓炎:一个验证研究
Sugihiro Hamaguchi1,2, Sei Takahashi1,3, Yuji Endo4
1Department of General Internal Medicine, Fukushima Medical University, Fukushima, JPN.
Cureus
|November 1, 2023
概括
脊柱中的一个大MRI信号不能准确地预测皮原性脊椎骨髓炎 (PVO) 中的抗生素治疗失败. 脊柱骨破坏显示了对治疗结果的轻度至中度预测准确性.
科学领域:
- 整形外科 整形外科 整形外科
- 放射学 放射学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 发烧性脊椎骨质炎 (PVO) 主要用静脉注射抗生素治疗.
- 外科手术只适用于抗生素治疗失败的病例,但它会带来挑战,特别是在患有并发病的老年患者中.
- 以前的研究表明MRI信号大小预测治疗失败,但需要用更大的样本大小进行验证.
研究的目的:
- 为了验证MRI发现的预测准确性,以确定PVO中抗生素治疗失败的MRI结果.
- 评估感染信号大小和其他MRI特征在预测治疗结果中的有用性.
主要方法:
- 在2006年至2021年期间诊断出PVO的82名患者的回顾性审查.
- 在诊断时对T1权重的斜腰脊柱MRI进行分析,重点关注运动段参与的百分比.
- 评估其他MRI发现,包括骨破坏,不稳定性和外周,以提高预测准确度.
主要成果:
- 在一个运动段中≥90%的感染信号显示了抗生素治疗失败的预测性能较差 (灵敏度为16.7%,特异性为70.3%).
- 受影响面积增加10%的ROC曲线下的面积为0.48.
- 脊柱骨破坏成为一个重要的预测因素,具有更高的预测准确性 (LR + 3.11).
结论:
- 在T1权重的MRI上显示大量的感染信号 (≥90%) 并不是PVO抗生素治疗失败的可靠预测指标.
- 在MRI中脊柱骨的破坏为PVO治疗结果提供了轻度至中度的预测价值.
相关概念视频
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
15
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
15
01:24Magnetic Resonance Imaging
5.2K
Magnetic resonance imaging (MRI) is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device in clinical use by the early 1980s. The early MRI...
5.2K