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消失的真空盘现象:脊柱感染的诊断关键
Fee C Keil1, Benjamin Simon Finger2, Niklas Laasch2
1Goethe University Frankfurt, University Hospital, Institute of Neuroradiology, Frankfurt am Main, Germany. fee.keil@unitybox.de.
概括
诊断发烧性脊椎病 (SD) 与退行性磁盘疾病 (DDD) 是一个挑战. 在重复的CT扫描中消失的真空盘现象 (VVDP) 显示出有希望的可用于准确区分传染性脊柱疾病.
科学领域:
- 放射学 放射学是指放射学
- 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:
- 从退行性磁盘疾病 (DDD) 区分发热性脊椎病 (SD) 提出了由于重叠的临床和放射性特征的诊断挑战.
- 准确的区分对于及时治疗和预防严重并发症至关重要.
研究的目的:
- 确定可靠的成像特征,以区分发热性SD和DDD,包括其侵蚀性亚型.
- 在这种差异化中评估消失真空盘现象 (VVDP) 的诊断实用性.
主要方法:
- 使用CT和MRI对163名患者 (92名SD,71名DDD) 的回顾性诊断准确性研究.
- 在诊断前获得的CT扫描上评估VVDP;病原体确认的SD作为参考标准.
- 统计分析包括千平方和费舍尔的精确测试.
主要成果:
- 在SD和DDD (27%对39%) 之间,脊椎间气体没有显著差异.
- 在99%的SD病例中存在相邻的或,但在DDD病例中没有 (P < 0.001).
- 在重复的CT扫描中,VVDP在一个子组 (10/10 SD vs 0/9 DDD) 中,在区分SD和DDD方面表现出100%的诊断准确性.
结论:
- 较高的CRP和WBC可以帮助区分SD和DDD.
- 重复CT扫描的VVDP是一种潜在的有价值的工具,可以更早,更准确地诊断感染性脊柱疾病.
- 整合临床,血清学和成像研究结果,特别是VVDP,可以提高诊断的信心.
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