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磁共振(MR)联合计算机断层扫描(CT)对股骨颈应力性损伤的诊断价值。

Diagnostic Value of Magnetic Resonance (MR) Combined with Computed Tomography (CT) in Patients with Stress Injury of Femoral Neck.

机构信息

Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China (mainland).

出版信息

Med Sci Monit. 2020 Sep 5;26:e922170. doi: 10.12659/MSM.922170.

Abstract

BACKGROUND The purpose of this research was to study and analyze the diagnostic value of magnetic resonance (MR) combined with computed tomography (CT) in patients with stress injury of the femoral neck. MATERIAL AND METHODS The 58 patients with stress injury of the femoral neck who were treated in our hospital from July 2017 until July 2019 were selected as subjects on the basis of clinical pathology and surgery, MR and CT examination, and related imaging data retrospectively analyzed. We observed all patients using different diagnostic methods to determine the value of diagnosis and treatment of disease. RESULTS The patients selected for this study were confirmed by clinicopathology and surgery; the positive rate of CT diagnosis was 65.5%, the positive rate of MR diagnosis was 74.1%, and the positive rate of combined diagnosis was 91.4%. Through statistical analysis, CT and MR showed no significant difference in the detection of stress lesions in different femoral necks, indicating no statistical significance (P>0.05). However, the amount of stress lesions detected in the combined diagnosis was higher than that in the two separate detection methods, with statistically significant difference (P<0.05). The grading of stress lesions in all patients examined through MR showed that there was no proportion of grade 0, whereas grades 3-4 were the highest, accounting for 20.7% and 32.8% respectively. In CT scanning of all patients, fracture lines were observed in 35 patients, of which 25 were transparent lines and 10 were strip dense shadows; Periosteal reaction was observed in 34 patients, of whom umbilical concave was observed in 18 patients. Osteoporosis was observed in 30 patients, and the lesion showed a zone of reduced density in the cortical bone, with a stripelike shape and unclear boundary. The density tended to increase in the cavum medullare of 32 patients, with porosis being visible. Compared with CT diagnosis, the accuracy, sensitivity, and specificity of MR detection were not significantly different (P>0.05). The accuracy, sensitivity, and specificity of the combined detection were higher than that of CT and MR detection alone, with statistically significant differences between groups (P<0.05). CONCLUSIONS The application of MR combined with CT in early clinical diagnosis and treatment of femoral neck stress injury will improve the diagnosis rate; the imaging signal is obvious, which is helpful to further evaluate the severity of disease.

摘要

背景

本研究旨在探讨和分析磁共振(MR)与计算机断层扫描(CT)联合应用于股骨颈应力损伤患者的诊断价值。

材料与方法

回顾性分析我院 2017 年 7 月至 2019 年 7 月收治的 58 例股骨颈应力损伤患者的临床病理及手术、MR 和 CT 检查等相关影像学资料,基于此选择研究对象。观察所有患者采用不同诊断方法的诊断及治疗疾病的价值。

结果

本研究患者经临床病理及手术证实;CT 诊断阳性率为 65.5%,MR 诊断阳性率为 74.1%,联合诊断阳性率为 91.4%。经统计学分析,CT 和 MR 在不同股骨颈的应力性病变检测中无明显差异,无统计学意义(P>0.05)。但联合诊断检测出的应力性病变量明显高于两种单独检测方法,差异有统计学意义(P<0.05)。所有患者经 MR 检查的应力性病变分级显示,无 0 级比例,3-4 级最高,分别为 20.7%和 32.8%。所有患者 CT 扫描观察到骨折线 35 例,其中透亮线 25 例,条状致密影 10 例;骨膜反应 34 例,其中脐凹 18 例。骨质疏松 30 例,皮质骨呈低密度区,呈条带状,边界不清。32 例髓腔密度趋于增高,可见疏松。与 CT 诊断比较,MR 检测的准确率、敏感度和特异度差异无统计学意义(P>0.05)。联合检测的准确率、敏感度和特异度均高于 CT 和 MR 单独检测,组间差异有统计学意义(P<0.05)。

结论

MR 联合 CT 在股骨颈应力损伤的早期临床诊断和治疗中应用,可提高诊断率;影像学信号明显,有助于进一步评估疾病严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aac/7491231/541a29eb7a2a/medscimonit-26-e922170-g001.jpg

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