改良X线检查方法对骨质疏松性椎体压缩骨折的诊断效能

目的探讨改良X线诊断骨质疏松性椎体压缩骨折的效能。方法回顾分析2013年1月至2015年6月于北京积水潭医院脊柱外科确诊的406例骨质疏松性椎体压缩骨折患者的病历资料。以骨折椎体作为病例组,以未骨折椎体作为对照组。首先测量侧位X线片上椎体的形变程度,计算传统诊断方法的诊断效能;随后测量正位X线片上椎体的形变程度,绘制椎体形变程度与骨折之间的ROC曲线,提出改良X线诊断方法,计算其诊断效能,并与传统诊断方法比较。结果406例骨折患者以胸腰段椎体骨折为主(83.00%)。传统诊断方法的灵敏度为56.65%(胸腰段56.68%),特异度为96.39%0x09(胸腰段93.87%),约登指数为0.530 4(胸腰段0.505 4)。改良X线诊断方法的灵敏度为71.67%(胸腰段81.90%),特异度为79.06%(胸腰段75.17%),约登指数为0.507 4(胸腰段0.570 7)。改良X线诊断方法的灵敏度高于传统诊断方法(P<0.001)。结论改良X线诊断方法能有效提高诊断的灵敏度,能够更好地帮助临床医生对骨质疏松性椎体压缩骨折进行初步诊断,特别是提高了对胸腰段椎体压缩骨折的诊断效能。

Efficacy of improved X-ray diagnosis method for osteoporotic vertebral compression fracture

Objective To investigate the efficacy of improved X-ray diagnosis method for osteoporotic vertebral compression fracture(OVCF).Methods The patients diagnosed with OVCF in Department of Spine Surgery,Beijing Jishuitan Hospital from January 2013 to June 2015 were retrospectively enrolled.The fractured vertebral bodies were taken as case group and the unfractured vertebral bodies as control group.Firstly,the degree of vertebral deformation on lateral view was measured to calculate the diagnostic efficacy of traditional diagnostic methods.Then,the degree of vertebral deformation on anteroposterior(AP)view was measured to draw the ROC curve between the degree of vertebral deformation and fracture.The improved X-ray diagnostic method was proposed to calculate its diagnostic efficacy and compare with traditional diagnostic methods.Results The main fracture was thoracolumbar vertebral fracture(83.00%)in 406 patients.All vertebral bodies and thoracolumbar vertebra of the included patients were diagnosed by the traditional diagnostic method,with the sensitivity of 56.65%(thoracolumbar 56.68%),the specificity of 96.39%(thoracolumbar 93.87%),and the Youden index of 0.530 4(thoracolumbar 0.505 4).Combined with the degree of vertebral deformation on AP view,the improved diagnostic method was proposed to diagnose all vertebral bodies and thoracolumbar vertebra of the included patients,with the sensitivity of 71.67%(thoracolumbar 81.90%),the specificity of 79.06%(thoracolumbar 75.17%),and the Youden index of 0.507 4(thoracolumbar 0.570 7).The sensitivity and efficiency of diagnosis of improved method was higher than the traditional method(P<0.001).Conclusion The improved X-ray diagnosis method of OVCF proposed in this study,on the basis of the original diagnostic method,improves the sensitivity and efficiency of the diagnostic method.