摘要
目的分析CT检查在髋关节置换术后并发症诊断中的应用价值。方法选取2020年1月-2023年4月在我院进行髋关节置换术治疗后发生相关并发症患者86例,所有患者均接受CT、MRI检查,由影像科一名经验丰富的医生给予影像学诊断。将临床最终诊断结果视为诊断金标准,计算CT、MRI诊断髋关节置换术后并发症敏感性、特异性、准确率。结果本研究纳入患者临床诊断结果:髋关节周围感染33例,无菌性松动26例,骨溶解17例,假瘤及假体周围骨折10例。CT检查在诊断髋关节周围感染方面的敏感性、特异性、准确率均低于MRI检查,诊断无菌性松动方面的准确率低于MRI检查(P<0.05);其他并发症诊断的敏感性、特异性、准确率与MRI诊断比较无显著差异(P>0.05)。髋关节周围感染CT检查主要表现为不规则缺损、中断的骨皮质轮廓,硬化缘表现不明显。无菌性松动CT检查主要表现为假体周围均匀透亮线影子,范围>2 mm。骨溶解CT检查主要表现为边界清晰的囊样透亮区,单发、多发均较为常见,部分形成硬化边。假瘤CT检查主要表现为假体周围软组织影,形状多为类圆形,部分患者可见点片状金属影。假体骨折CT检查主要表现为骨皮质中断,断端轻微移位。结论髋关节置换术后并发症在CT检查图像上具有特异性表现,临床诊断准确率较为理想,仅在无菌性松动以及骨溶解诊断方面表现不佳,总体诊断应用价值较高。
Objective:To analyze the value of CT examination in the diagnosis of complications after hip replacement.Methods:A total of 86 patients with related complications after hip replacement in our hospital from January 2020 to April 2023 were selected.All patients received CT and MRI examination,and an experienced doctor in the imaging department gave imaging diagnosis.The sensitivity,specificity and accuracy of CT and MRI in diagnosing postoperative complications after hip replacement were calculated.Results:The clinical diagnosis of the patients included in this study were 33 cases of peri-hip infection,26 cases of aseptic loosening,17 cases of osteolysis and 10 cases of pseudotumor and periprosthetic fracture.The sensitivity,specificity,and accuracy of CT in diagnosing peri-hip infection were lower than those of MRI,and the accuracy in diagnosing aseptic loosening was lower than that of MRI(P<0.05).There was no difference in the sensitivity,specificity and accuracy between CT and MRI in the diagnosis of other complications(P>0.05).CT examination of hip periarticular infection mainly shows irregular defect and interrupted cortical bone contour,with insignificant sclerotic margin.CT examination of aseptic loosening mainly shows uniform transparent line shadow around the prosthesis,with a range>2 mm.CT examination of osteolysis mainly shows well-circumscribed cystoid lucent areas,which are common in both single and multiple cases,with some forming sclerotic edges.CT examination of pseudotumor:The main manifestation is that the soft tissue around the prosthesis should be round in shape,and some patients can see dot-sheet metal shadows.CT examination of prosthesis fracture mainly shows interruption of bone cortex and slight displacement of the broken end.Conclusion:The complications of hip replacement have specific manifestations on CT images,and the accuracy rate of clinical diagnosis is satisfactory,which has poor performance in the diagnosis of aseptic loosening and osteolysis,with high overall diagnostic value.
作者
曾鸣
胡建兵
李根林
ZENG Ming;HU Jian-bin;LI Gen-lin(People's Hospital of De'an County,Jiujiang Jiangxi 330400,China)
出处
《透析与人工器官》
2024年第1期46-49,共4页
Chinese Journal of Dialysis and Artificial Organs
