螺旋CT对脊椎结核与肿瘤诊断及鉴别诊断的价值

摘要

目的 探讨螺旋CT对脊椎结核与肿瘤的诊断及鉴别诊断的价值.方法 回顾分析经病理证实的86例脊椎结核和肿瘤病例.结果 82例脊椎结核螺旋CT表现为椎体溶蚀性骨质破坏,小片状死骨形成,椎间盘破坏,椎间隙狭窄,以及椎旁寒性脓肿形成.4例脊椎肿瘤表现为椎体及附件骨质破坏,并椎旁软组织肿块形成,均未累及椎间盘.结论 螺旋CT在脊椎结核与肿瘤的诊断及鉴别诊断中具有重要价值.%Objective To determine the prospective value of thin slice FIESTA and magnetic resonance cholangiopancreatography( MRCP ) in the detection of bile duct stones before laparoscopic cholecystectomy. Methods Information of 338 patients with cholelithiasis which received thin slice FIESTA and MRCP or B ul-trasonography and surgeries were reviewed. Results 87 of 338 patiets were diagnosed to have calculus of bile duct after the operation, overall diagnostic accuracy rates of MRCP + FIESTA and B ultrasound diagnosis of bile duct stones were 97.7% and 79.3% respectively,significantly different x2 =28.93 ,P <0.01 ). Accord-ing to the size of stone,the deteciton rate of S2 cm group and 1-2 cm group were not different by two methods ( both P > 0.05 ); however, the detection rate of MRCP and thin slice FIESTA is obviosly higher than that of ul-trasound( x2 =35. 56,P <0.01 )in < 1 cm group. Conclusion The accurate determination of bile duct stones and its size should be based on the findings of thin slice FIESTA and MRCP images; comprehensive analysis of thin slice FIESTA and MRCP images can provide information for operation planning before laparoscopic chole-cystectomy.