骨感染性病变诊断中CT平扫联合三维重建技术的临床价值

发布时间：2018-07-29 10:20

【摘要】：目的探讨骨感染性病变CT平扫及三维重建成像的特点,为提高CT在骨感染性病变诊断中的价值。方法回顾性调查2010年1月-2014年11月经手术病理或穿刺病理证实为骨感染性病变患者30例临床资料,分析治疗前CT平扫和三维重建图像的特点,采用GE Lightspeed 64层螺旋CT机扫定位像。结果 30例骨感染性病变患者中有13例为急性感染,占43.3%;感染患者检出病原菌分别为结核分枝杆菌、金黄色葡萄球菌、铜绿假单胞菌及布鲁氏杆菌,分别占53.4%、40.0%、3.3%、3.3%;30例骨感染性病变患者CT表现阳性有病骨周围出现软组织肿块、脓肿、骨质呈溶骨性破坏、病灶内出现明显死骨、边缘出现硬化、有明显骨膜反应、病灶内出现积气及VR成像后骨质出现明显缺损,阳性率分别为10.0%、60.0%、96.7%、70.0%、46.7%、36.7%、30.0%及43.3%。结论骨感染性的病变的CT典型表现为边界不清楚溶骨性的骨质破坏、可见明显死骨形成,不同致病菌所致的骨感染CT变现各具特点,各种类型骨感染性疾病的确诊需要结合病原学和病理学。
[Abstract]:Objective to investigate the features of CT plain scan and three dimensional reconstruction of bone infectious lesions and to improve the value of CT in the diagnosis of bone infectious diseases. Methods from January 2010 to November 2014, the clinical data of 30 patients with bone infection proved by pathology or puncture pathology were retrospectively investigated. The features of CT plain scan and 3D reconstruction before treatment were analyzed. GE Lightspeed 64-slice spiral CT scanning was used to locate the lesions. Results among the 30 cases of bone infection, 13 cases were acute infection (43.3%), and the pathogens were Mycobacterium tuberculosis, Staphylococcus aureus, Pseudomonas aeruginosa and Brucella. There were 30 cases of bone infectious diseases with positive CT findings, soft tissue masses, abscess, osteolytic destruction, obvious dead bone in the lesion, sclerosis at the edge, and obvious periosteal reaction. There were obvious defects in the bone of the lesions after gas accumulation and VR imaging, and the positive rates were 10.0 and 60.0, respectively. The positive rates were 30.0% and 43.3%, respectively, and 70.0% and 46.70.The positive rates were 30.0% and 43.3%, respectively. Conclusion the typical CT manifestation of bone infection is the destruction of bone which is not clear about the boundary of osteolysis, and the formation of dead bone is obvious. The CT features of bone infection caused by different pathogenic bacteria are different. The diagnosis of various types of bone infections requires a combination of etiology and pathology.
【作者单位】：杭州师范大学附属医院放射科;
【基金】：国家自然科学基金资助项目(1400521661)
【分类号】：R681;R816.8

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