数字化断层融合诊断腰椎单纯峡部不连的临床应用价值

目的 探讨数字化断层融合（digital tomosynthesis,DTS）对诊断腰椎单纯峡部不连的临床应用价值.方法 对39例临床怀疑腰椎峡部不连的病例进行X线双斜位平片、冠状位和斜位及矢状位DTS检查,判断是否为腰椎峡部不连,评价X线平片与DTS对腰椎峡部不连诊断的敏感性和总诊断符合率,并对X线平片和DTS图像显示椎弓峡部的能力进行评价.结果 X线平片确诊腰椎峡部不连19例,8例不确定,12例排除腰椎峡部不连.32例患者经DTS确诊为腰椎峡部不连,2例不确定,5例排除腰椎峡部不连,X线平片诊断腰椎峡部不连的敏感性和总诊断符合率为55.9％、61.5％,DTS诊断腰椎峡部裂的敏感性和总诊断符合率为94.1％、94.9％,DTS的诊断符合率与X线平片比较有差异具有统计学意义（χ^2=11.08,P＜0.05）.结论 DTS可以清晰显示单纯腰椎峡部不连,与X线平片比较,能显著提高单纯腰椎峡部不连的检出率,可作为X线平片的有效补充.

Clinical application value of digital tomosynthesis in diagnosis for simplex pars interarticularis defects in lumbar vertebra

Objective To investigate the application value of digital tomosynthesis （DTS） in diagnosis for simplex pars interarticularis defects in lumbar vertebra. Methods 39 patients who were suspected as pars interarticularis defects were underwent DTS examination. Then it was determined that if the pars interarticularis defects existed. In addition, the sen- sitivity and coincidence were analyzed. Results In radiograph, pars interarticularis defects was diagnosed clearly in 19 pa- tients, 8 cases were uncertainty and 12 patients were eliminated. After the DTS examination, pars interarticularis defects was diagnosed clearly in 32 patients, 2 cases were uncertainty and 5 patients were eliminated. The sensitivity and accuracy was 55.9%and 61.5% respectively in radiograph, and was 94. 1% and 94.9% in DTS. There were significant differences between the coincidence in DTS and in radiograph （χ^2= 11.08, P〈0.05）. Conclusion DTS can display the pars interar- ticularis defects clearly. Comparing with radiograph, DTS can markedly increase the detection rate. It can be an effective supplementary for radiograph.