肌骨超声及CT诊断慢性腰痛的效果比较

目的 比较肌骨超声与CT对慢性腰痛的诊断效果.方法 选取我院2016年1月到2017年6月期间收治的慢性腰痛患者60例作为观察组,另选取健康成年人58例作为对照组.两组均行肌骨超声及CT检查,测量L4两侧多裂肌横截面积.观察组患者经治疗缓解后再次测量.利用ROC曲线分析CT诊断多裂肌横截面积的最佳诊断截点,并分析肌骨超...

Comparison of the Effect of Musculoskeletal Ultrasound and CT in the Diagnosis of Chronic Low Back Pain

Objective To compare the diagnostic effect of musculoskeletal ultrasound and CT in chronic low back pain.Methods Sixty patients with chronic low back pain admitted to our hospital from January 2016 to June 2017 were selected as observation groups and 58 healthy adults as a control group.Both groups were examined by muscle-bone ultrasound and CT,and the cross-sectional area of L4 bilateral multifid us muscle was measured.The patients in the observation group were measured again after remission.ROC curve was used to analyze the best diagnostic cut-off point of CT in diagnosing the cross-sectional area of multifidus muscle,and the diagnostic efficacy of musculoskeletal ultrasound and CT in chronic low back pain was analyzed.Results CT and muscle-bone ultrasound measurements showed no significant difference between the two methods(P>0.05).Compared with the control group.The cross-sectional area of the observation group was significantly smaller than that of the control group(P<0.05).Among 118 subjects,57 cases were diagnosed as chronic low back pain by CT,61 cases were healthy,4 cases were misdiagnosed and 7 cases were missed,the diagnostic accuracy rate was 90.68%.56 cases were diagnosed as chronic low back pain by musculoskeletal ultrasound,62 cases were healthy,4 patients were misdiagnosed and 8 patients were missed.The diagnostic accuracy rate was 89.83%.ROC curve analysis showed that there were no significant differences in sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and accuracy between CT and musculoskeletal ultrasound in the diagnosis of chronic low back pain(P>0.05).The areas under the curves were 0.908 and 0.899,respectively,which had higher diagnostic efficiency(AUC>0.5).The cross-sectional a rea of multifidus muscle in the observation group increased gradually after treatment.The data obtained after 4 months and 6 months of treatment were significantly different from those before treatment(P<0.05).Conclusion Measuring the cross-sectional area of multifidus muscle by musculoskeletal ultrasound can be as effective as CT in diagnosing chronic low back pain,and it has the adva ntages of convenience,economy,simple operation,no radiation and repeatable operation.