X线、CT及MRI对髋关节置换术后并发症的诊断价值

发布时间：2018-05-01 17:29

本文选题：髋关节置换 + 并发症　；参考：《中国医学计算机成像杂志》2015年03期

【摘要】：目的:探讨髋关节置换术后常见并发症的X线、CT及MR表现,评价三者的诊断价值。方法:回顾性分析44例髋关节置换术后出现并发症行翻修术的病例,观察其X线、CT及MRI表现,并与手术及病理结果对照,统计分析三者诊断无菌性松动、骨溶解及感染的敏感性与特异性,以及三者诊断准确性。结果:44例患者术后并发症包括无菌性松动、骨溶解、感染、假瘤及假体周围骨折。X线、CT及MRI诊断无菌性松动的敏感度分别为84%、78%、80%,特异度分别为76%、81%、94%;诊断骨溶解的敏感度分别为73%、86%、78%,特异度分别为88%,100%,86%;诊断感染的敏感度分别是50%、60%、100%,特异度分别为72%、74%、100%。三者诊断假体无菌性松动及骨溶解的准确性无明显统计学差异(P0.05),在诊断假体周围感染的准确性方面,X线和CT二者间无明显统计学差异(P0.05),但都明显低于MRI(P0.05)。结论:在髋关节置换术后并发症的诊断方面,X线、CT及MRI互为补充,但其中MRI是观察假体周围感染的最佳手段。
[Abstract]:Objective: to evaluate the diagnostic value of X-ray CT and Mr findings of common complications after hip arthroplasty. Methods: Forty-four patients with complications after hip arthroplasty were analyzed retrospectively. X-ray CT and MRI findings were observed and compared with the results of operation and pathology. The results were statistically analyzed to diagnose aseptic loosening. Sensitivity, specificity and diagnostic accuracy of osteolysis and infection. Results 44 cases of postoperative complications included aseptic loosening, osteolysis, infection. The sensitivity of CT and MRI in the diagnosis of aseptic loosening was 84 and 7880, and the specificity was 7681 / 94, respectively; the sensitivity of diagnosis of osteolysis was 73,86867878, and the specificity was 8880.The sensitivity of diagnosing infection was 500.6060100, and the specificity was 722 / 7474100. There was no significant difference in the accuracy of diagnosis of aseptic loosening and osteolysis among the three groups (P 0.05). There was no significant difference between X ray and CT in the diagnosis of periprosthetic infection (P 0.05), but it was significantly lower than that in MRIV (P 0.05). Conclusion: X-ray CT and MRI supplement each other in the diagnosis of complications after hip arthroplasty, but MRI is the best method to observe periprosthetic infection.
【作者单位】：上海交通大学医学院附属瑞金医院放射科;上海交通大学医学院附属瑞金医院骨科;
【基金】：国家自然基金No.81372000~~
【分类号】：R687.4;R445.2;R816.8

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