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基于计算机断层扫描的脊椎骨破坏分类在诊断成年脊柱结核病的预测价值

Zhaoliang Dong¹, Shuai Wang², Chenguang Jia³

¹Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, PR China; Department of Orthopedics, Hebei Chest Hospital, Hebei Lung Cancer Research Center, Shijiazhuang, Hebei, China.

World neurosurgery

|January 13, 2024

概括

计算机断层扫描 (CT) 在脊髓结核病 (TB) 中显示出明显的骨损伤模式. 一个碎片/骨解模式,特别是特定的磁共振成像 (MRI) 发现,强烈表明脊柱结核病.

科学领域:

放射学放射学是一门学科.
传染性疾病传染性疾病
整形外科整形外科整形外科

背景情况:

脊柱结核病 (TB) 的诊断通常依赖于磁共振成像 (MRI).
计算机断层扫描 (CT) 在评估脊柱结核病的骨破坏模式方面发挥着至关重要的作用.
了解基于CT的骨损伤特征可以提高诊断准确度.

研究的目的:

根据在3DCT图像中观察到的骨损伤模式来表征脊柱结核病.
为了研究脊柱结核病和特定的CT识别的骨损伤模式之间的关系.
评估CT骨损伤模式对脊柱结核病的诊断价值.

主要方法:

161名受试者使用X-pert MTB/RIF被分类为结核病阳性或结核病阴性.
在3DCT上的骨损伤模式被分类为碎片,骨解,硬化或缺席的骨损伤.
病变模式的诊断价值在各组之间进行了比较.

主要成果:

在161名患者中,99名为结核病阳性,62名为结核病阴性.
在34.8%的患者中存在碎片/骨解性病变,在45.9%的患者中存在骨解性病变,在8.1%的患者中存在骨硬性病变,在11.2%的患者中没有破坏.
碎片/骨解模式与脊髓结核有很强的关联 (OR 3.33),与特定的MRI发现显著增加 (OR 15.58).

结论:

绝对的骨解病变是观察到的最常见的模式.
在CT上的碎片/骨解性骨损伤模式高度暗示脊柱结核病.
将这种CT图案与MRI发现 (细壁,广泛的脊椎破坏,下带扩散) 结合起来,进一步提高了诊断确定性.

关键词:

计算机断层扫描的发现预测值是一个预测值.脊柱结核病是一种脊柱结核病.三维视图视图的三维视图脊椎骨的破坏脊椎骨的破坏

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