放射性核素与影像学用于人工关节置换假体松动及感染诊断分析

发布时间：2018-01-28 08:47

本文关键词： 放射性核素骨显像影像学人工关节置换假体松动感染　出处：《中华医院感染学杂志》2015年14期 　论文类型：期刊论文

【摘要】：目的探讨放射性核素骨显像联合影像学用于人工关节置换后假体松动及感染的诊断价值,以提高诊断率。方法回顾性分析2011年1月-2014年3月医院收治的32例疑似人工关节置换后假体松动及髋关节置换感染患者,所有患者均经过放射性核素骨显像、X线、CT诊断,以术中所见、术后病理、细菌培养结果作为金标准,计算3种方法检查诊断结果的一致性以及相关的诊断学评价指标。结果术中所见共诊断24例假体松动患者,放射性核素骨显像检查发现22例假体松动患者,两种检查方法的一致性检验为Kappa值=0.385,P=0.028;细菌培养及病理检查诊断感染患者21例,放射性核素骨显像诊断20例,两种检查方法的一致性检验为Kappa值=0.390,P=0.027;放射性核素骨显像、X线、CT检查共发现24例假体松动患者,与术中所见结果检查方法的一致性检验为Kappa值=0.667,P0.01;放射性核素骨显像、X线、CT检查共发现22例感染患者,与细菌培养及病理检查诊断检查方法的一致性检验为Kappa值=0.646,P0.01。结论放射性核素骨显像联合影像学手段用于人工关节置换后假体松动及感染,能够显著提高诊断结果的灵敏度、特异度,降低漏诊率和误诊率。
[Abstract]:Objective to evaluate the diagnostic value of radionuclide bone imaging combined with radionuclide bone imaging in the diagnosis of prosthesis loosening and infection after arthroplasty. Methods from January 2011 to March 2014, 32 patients with suspected prosthesis loosening and hip replacement infection after artificial joint replacement were analyzed retrospectively. All the patients were diagnosed by radionuclide bone imaging and X-ray CT. The results of intraoperative, postoperative pathology and bacterial culture were taken as the gold standard. Results 24 patients with pseudosome loosening were diagnosed during operation and 22 patients were found by radionuclide bone scintigraphy. The consistency test of the two methods was as follows: the Kappa value was 0. 385 and 0. 028; Bacterial culture and pathological examination were performed in 21 patients with infection and 20 patients with radionuclide bone scintigraphy. The consistency test of the two methods was as follows: the Kappa value was 0.390%. Radionuclide bone scintigraphy was performed in 24 patients with pseudosome loosening. The consistency test between radionuclide bone scintigraphy and intraoperative results was 0.667g / P0.01. Radionuclide bone scintigraphy revealed 22 cases of infection by X-ray CT. The consistency of radionuclide bone scintigraphy with the methods of bacterial culture and pathological diagnosis was 0.646. Conclusion Radionuclide bone imaging combined with radionuclide bone imaging for prosthesis loosening and infection after artificial joint replacement can significantly improve the sensitivity and specificity of the diagnostic results and reduce the rate of missed diagnosis and misdiagnosis.
【作者单位】：河南科技大学第一附属医院核医学科;
【基金】：中华医院感染控制研究基金项目(ZHYY-2011-038)
【分类号】：R687.4;R817.4
【正文快照】： 动与感染,也是临床中常见的并发症[1]。本研究主要以2011年1月-2014年3月医院收治的32例怀疑人工关节置换后假体松动及髋关节置换感染患者为研究对象,分析放射性核素骨显像联合多种影像学诊断人工关节置换后假体松动及感染的临床价值。现将调查结果报道如下。1资料与方法1.1临

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