磁共振弥散加权联合血清C-反应蛋白检测诊断骨感染性疾病价值

发布时间：2018-06-13 02:02

本文选题：磁共振弥散加权呈像 + C-反应蛋白　；参考：《中华医院感染学杂志》2015年02期

【摘要】：目的探讨磁共振弥散加权呈像(DWI)联合血清C-反应蛋白(CRP)对骨感染的临床诊断价值,为临床诊断提供参考。方法选取2012-2014年66例疑似骨感染患者作为研究对象,分别采用酶联免疫吸附法(ELISA)检测其血清CRP水平,磁共振DWI扫描检测其病变组织的表观弥散系数(ADC)及对比噪声比(CNR),并最终采用病理学、细胞学方法对患者骨感染进行确诊,观察并比较血清CRP及磁共振DWI单独及联合检测诊断骨感染的准确度、灵敏度及特异度;采用κ检验比较三者与病理学/细胞学确诊的符合程度。结果恶性肿瘤骨转移患者ADC值显著低于骨感染患者,而CNR值则显著高于骨感染患者(P0.05);血清CRP检测诊断骨感染的准确度77.27%、灵敏度81.40%、特异度69.57%;磁共振DWI扫描单独检测诊断骨感染的准确度86.36%、灵敏度88.37%、特异度82.61%;血清CRP联合磁共振DWI扫描诊断骨感染的准确度92.42%、灵敏度93.02%、特异度91.30%;联合检测诊断与确诊诊断的符合程度显著高于血清CRP单检及磁共振DWI扫描单独检测(P0.05)。结论血清CRP联合磁共振DWI扫描对骨感染具有较高的诊断及鉴别诊断价值,值得推广应用。
[Abstract]:Objective to evaluate the value of diffusion weighted imaging (DWI) combined with serum C-reactive protein (CRP) in the diagnosis of bone infection. Methods 66 patients with suspected bone infection from 2012 to 2014 were selected as study subjects, and their serum CRP levels were detected by Elisa. The apparent diffusion coefficient (ADCC) and the contrast noise ratio (CNRR) of the lesions were detected by DWI, and the bone infection was diagnosed by pathology and cytology. The accuracy, sensitivity and specificity of serum CRP and Mr DWI in the diagnosis of bone infection were observed and compared. Results ADC values in patients with bone metastasis were significantly lower than those in patients with bone infection. The CNR value was significantly higher than that of bone infection patients (P 0.05), the accuracy of serum CRP in the diagnosis of bone infection was 77.27, the sensitivity was 81.40, the specificity was 69.57; the accuracy of DWI alone was 86.36, the sensitivity was 88.37 and the specificity was 82.61; the serum CRP was combined with CRP. The accuracy, sensitivity and specificity of Mr DWI in diagnosis of bone infection were 92.42, 93.02 and 91.30 respectively. The coincidence between combined detection and diagnosis was significantly higher than that in serum CRP and DWI alone. Conclusion Serum CRP combined with Mr DWI is valuable in the diagnosis and differential diagnosis of bone infection and is worth popularizing.
【作者单位】：天津医科大学研究生院;武警后勤学院附属医院科研科;武警后勤学院附属医院磁共振科;
【基金】：国家自然科学基金资助项目(81170238)
【分类号】：R445.2;R681.2

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