摘要
目的:探讨螺旋CT和MRI对平片阴性的衰竭骨折的早期诊断价值。材料与方法:31例经X线平片检查无明显异常而临床高度怀疑衰竭骨折的病人,进一步行CT和MRI检查。分析确诊病例CT和MRI表现。比较两种检查方法的敏感度、特异度、准确性及观察者间符合度。结果:19例病人确诊为衰竭骨折。CT主要表现为线样模糊低密度影,在脊椎多为线片样高密度。MRIT1WI多表现为低或略低信号,T2WI为高低混杂信号,STIR多呈明显高信号。CT和MRI诊断的敏感度、特异度、准确性分别为89%?95%、92%?67%、90%?84%,但差异均无统计学意义(P>0.05)。CT的观察者间符合度优于MRI,Kappa值分别为0.728,0.459。结论:螺旋CT与MRI均有助于平片阴性衰竭骨折的早期诊断,但螺旋CT的准确性略高于MRI,可能因为螺旋CT具有较好的特异性。
Objective To investigate the value of helical CT and MRI in early diagnosis of radiographically negative insufficiency fractures. Materials and Methods Thirty one radiographically negative patients were evaluated with CT and MRI because of high clinical suspicion of insufficiency fractures. The CT and MRI findings were analyzed and the sensitivity specificity accuracy and interobserver agreement of both imaging modalities were calculated and compared. Results The diagnosis was eventually confirmed in 19 patients. The main CT findings were linear obscured low density but linear or patchy high density was observed in vertebra. The main MRI findings were low or slightly low low or high high signal intensity on T1WI T2WI STIR respectively. The sensitivity specificity accuracy of CT and MRI is 89%95% 92%67% 90%84% respectively. However no statistically significant difference was found between the two imaging modalities. Interobsever agreement of CT was better than MRI with Kappa value of 0.728 and 0.459 respectively. Conclusion Helical CT and MRI are both valuable in early diagnosis of radiographically negative insufficiency fractures but helical CT is slightly superior to MRI probably due to its better specificity.
出处
《中国临床医学影像杂志》
CAS
北大核心
2005年第1期47-49,共3页
Journal of China Clinic Medical Imaging
关键词
骨折
应力性
体层摄影术
X线计算机
磁共振成像
fractures stress tomography X ray computed magnetic resonance imaging
