腰椎峡部裂临床诊断中多层螺旋CT重组技术的应用及准确性研究

曹源 宋冬冬 崔兆国 于晶

【摘要】 目的：探究腰椎峽部裂临床诊断中多层螺旋CT重组技术的应用及准确性。方法：选取2018年1月-2020年1月本院收治的腰椎峡部裂患者88例，按随机数字表法将其分为对照组与研究组，每组44例。对照组进行常规X线片扫描，研究组进行多层螺旋CT重组技术检查。两组均经手术治疗且确诊，比较两组诊断情况、腰椎弓峡部骨质不连检出情况以及不同病变显示情况。结果：研究组误诊率与漏诊率均低于对照组，诊断准确率高于对照组（P<0.05）。两组均存在44处腰椎弓峡部骨质不连。研究组腰椎弓峡部骨质不连检出率为100%高于对照组的79.5%（P<0.05）;研究组骨质增生硬化、关节面侵蚀、关节面下骨质囊变和软组织肿胀显示率均高于对照组（P<0.05）。结论：将多层螺旋CT重组技术应用于腰椎峡部裂临床诊断中，不仅能够减少漏诊、误诊率，提高其临床诊断准确率，同时还能够有效清晰地显示机体内存在的腰椎弓峡部骨质不连、不同病变情况，为临床治疗和预后提供科学性依据，值得推广应用。

【关键词】 腰椎峡部裂 临床诊断 多层螺旋CT重组技术 准确性

Application and Accuracy of Multi-slice Spiral CT Reconstruction Technology in Clinical Diagnosis of Lumbar Spondylolysis/CAO Yuan， SONG Dongdong， CUI Zhaoguo， YU Jing. //Medical Innovation of China， 2021， 18（10）： -121

[Abstract] Objective： To explore the application and accuracy of multi-slice spiral CT reconstruction technology in the clinical diagnosis of lumbar spondylolysis. Method： A total of 88 patients with lumbar spondylolysis admitted to our hospital from January 2018 to January 2020 were selected. They were divided into control group and study group according to random number table method， with 44 cases in each group. Routine X-ray scanning was performed in the control group， and multi-slice spiral CT reconstruction technology was performed in the study group. Both groups received surgical treatment and confirmed diagnosis. The diagnosis， the detection of bone nonunion in lumbar isthmus and the manifestation of different lesions were compared between the two groups. Result： The rate of misdiagnosis and missed diagnosis in the study group were lower than those in the control group， and the diagnostic accuracy was higher than that in the control group （P<0.05）. There were 44 lumbar isthmus nonunion in both groups. The detection rate of vertebral isthmus bone nonunion in the study group was 100% higher than 79.5% in the control group （P<0.05）. The display rates of hyperplasia and sclerosis， articular surface erosion， subarticular cystic degeneration and soft tissue swelling in the study group were higher than those in the control group （P<0.05）. Conclusion： The application of multi-slice spiral CT reconstruction technology in the clinical diagnosis of lumbar spondylolysis can not only reduce the rate of missed diagnosis and misdiagnosis， improve the accuracy of clinical diagnosis， but also effectively and clearly show the lumbar spondylolysis bone nonunion and different pathological changes in the body， so as to provide scientific basis for clinical treatment and prognosis， which is worthy of popularization and application.

[Key words] Lumbar spondylolysis Clinical diagnosis Multi-slice spiral CT reconstruction technology Accuracy

First-authors address： Zhongshan Hospital Affiliated to Dalian University， Dalian 116001， China

doi：10.3969/j.issn.1674-4985.2021.10.028

腰椎峡部裂症状出现时，机体内的腰椎一侧或两侧椎弓的上下关节突间存在峡部骨质缺损不连续情况，在临床上又称为椎弓峡部裂（峡部不连），病情持续发展极易出现腰椎真性椎体滑脱症[1]。此部位具有特殊的解剖结构，具有固定上下关节突起的作用，因此该部位损害对机体产生极大的威胁[2]。临床上及时和准确的诊断方式为患者的临床治疗提供良好的前提条件，传统临床上主要应用常规X线片进行诊断，但其易受外界因素的影响，极易产生漏诊、误诊等情况，效果欠佳[3]。现阶段，多层螺旋CT重组技术逐渐应用于腰椎峡部裂临床诊断中，提高了诊断准确率，效果理想[4]。本研究分析了腰椎峡部裂临床诊断中多层螺旋CT重组技术的应用及准确性，现报道如下。

1 资料与方法

1.1 一般资料 选取2018年1月-2020年1月本院收治的腰椎峡部裂患者88例。纳入标……