MSCT和X线平片在诊断腰椎滑脱症中的临床价值比较
MSCT and X-ray: The Comparison of Clinical Value in the Diagnosis of Lumbar Spondylolisthesis
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摘要: 目的:比较X线平片和多排螺旋CT诊断腰椎滑脱的准确性,并评价临床价值。方法:搜集40例经X线平片、MSCT检查诊断并手术治疗的腰椎滑脱患者,X线平片和MSCT判定腰椎滑脱程度、部位、类型的结果与手术对照。结果:40例患者,27例手术证实为真性滑脱,13例为假性滑脱。以手术为对照,X线平片、MSCT诊断腰椎滑脱程度和部位准确率为100%;X线平片判定腰椎滑脱类型的敏感性、特异性、阳性和阴性预测值为分别为59.3%、100%、100%和54.2%;MSCT判定滑脱类型的敏感性、特异性、阳性和阴性预测值均为100%;X线平片和MSCT对滑脱类型判定具有明显统计学差异(P<0.01)。结论:X线平片、MSCT判定腰椎滑脱程度和部位均具有较高的准确性;判定腰椎滑脱类型,MSCT比X线平片好,X线平片目前仍是基本的筛查方法,MSCT进一步明确腰椎滑脱类型诊断,为临床提供更多的影像信息和治疗方案。Abstract: Objective: To evaluate the accuracy of MSCT and X-ray diagnosis of lumbar spondylolisthesis.Methods: 40 lumbar spondylolisthesis cases who received the operation after the plain X-ray film and MSCT examination.Contrast the degrees,positions and type of lumbar spondylolisthesis examined by X-ray film and MSCT with the operation result.Results: the operation result showed that 27 cases were true spondylolisthesis and 13 cases were false spondylolisthesis.Contrasted with the operation result,the accuracy of lumbar spondylolisthesis type and position examined by MSCT and X-ray is 100 %;predicted values of sensitivity specificity positive and negative results of the spondylolisthesis judged by plain X-ray film are 59.3 %,100 %,100 % and 54.2 % respectively.Predicted values of sensitivity specificity positive and negative result of the olisthy judged by MSCT are all 100 % in the four above-mention aspects.There is apparently statistical disparity between olisthy properties examined by X-ray and MSCT(P<0.01).Conclusion: Both X-ray and MSCT can examine the degrees and positions of lumbar spondylolisthesis accurately,and MSCT can judge the lumbar spondylolisthesis type more accurately than X-ray apparently.X-ray screening is still the basic method;MSCT can make a further definite diagnosis of the type and offer more valuable image information for clinical treatment.
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