潜水员减压性骨坏死影像学检查26例随访观察

发布时间：2018-11-02 12:18

【摘要】：目的比较分析影像学方法中的电子计算机断层扫描(CT)、磁共振成像技术(MRI)与X射线平片间诊断减压性骨坏死(DON)的诊断优势。方法选择26名工龄1 a的潜水员,随访观察3 a,分别进行双肩、双髋、双膝关节X射线平片、CT、MRI检查,各2次。分析各种方法诊断DON的检出率和病灶重现性(率)。结果两次检查CT的检出率(76.9%和80.8%)明显高于X射线平片的检出率(30.8%和30.8%),第2次检查MRI的检出率(61.5%)明显高于X射线平片的检出率(30.8%),差异有显著性(P0.05);X射线平片、CT和MRI的病灶重现率分别为46.2%,91.8%,77.4%。经Kappa一致性检验分析,X射线平片Kappa值为0.392,无显著意义(P0.05);CT Kappa值为0.839,有极好的一致性(P=0.000);MRI Kappa值为0.506,有中度或高度一致性(P0.05)。结论CT、MRI对DON检出率较高,且具有病灶重现性好、诊断符合率高的优点,是目前较为理想的减压性骨坏死的影像学诊断方法。
[Abstract]:Objective to compare the diagnostic advantages of computed tomography (CT), magnetic resonance imaging (MRI) and X-ray plain film in the diagnosis of decompression osteonecrosis (DON). Methods 26 divers with 1 year working age were followed up for 3 years. X-ray radiographs were performed on the shoulders, hips and knees respectively, and CT,MRI was performed twice each. The detection rate and recurrence rate of DON were analyzed. Results the detection rate of CT (76.9% and 80.8%) was significantly higher than that of X-ray plain film (30.8% and 30.8%). The detection rate of MRI in the second examination (61.5%) was significantly higher than that in X-ray plain film (30.8%), and the difference was significant (P0.05). The recurrence rates of X-ray plain film, CT and MRI were 46.2 and 77.4, respectively. By Kappa consistency test, the Kappa value of X-ray plain film was 0.392, no significant (P0.05); CT Kappa value was 0.839, excellent consistency (P0. 000); MRI Kappa value was 0. 506, moderate or high consistency (P0.05). Conclusion CT,MRI is an ideal imaging method for the diagnosis of decompression osteonecrosis.
【作者单位】：上海市杨浦区中心医院上海市杨浦区中心医院上海市杨浦区中心医院上海市杨浦区中心医院上海市杨浦区中心医院
【分类号】：R84

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