CAJ | 학술논문

目的：探讨骨感染性病变CT 平扫及三维重建成像的特点，为提高CT 在骨感染性病变诊断中的价值。方法回顾性调查2010年1月－2014年11月经手术病理或穿刺病理证实为骨感染性病变患者30例临床资料，分析治疗前CT平扫和三维重建图像的特点，采用GE Lightspeed 64层螺旋CT机扫定位像。结果30例骨感染性病变患者中有13例为急性感染，占43．3％；感染患者检出病原菌分别为结核分枝杆菌、金黄色葡萄球菌、铜绿假单胞菌及布鲁氏杆菌，分别占53．4％、40．0％、3．3％、3．3％；30例骨感染性病变患者C T表现阳性有病骨周围出现软组织肿块、脓肿、骨质呈溶骨性破坏、病灶内出现明显死骨、边缘出现硬化、有明显骨膜反应、病灶内出现积气及V R成像后骨质出现明显缺损，阳性率分别为10．0％、60．0％、96．7％、70．0％、46．7％、36．7％、30．0％及43．3％。结论骨感染性的病变的C T典型表现为边界不清楚溶骨性的骨质破坏、可见明显死骨形成，不同致病菌所致的骨感染CT变现各具特点，各种类型骨感染性疾病的确诊需要结合病原学和病理学。
목적：탐토골감염성병변CT 평소급삼유중건성상적특점，위제고CT 재골감염성병변진단중적개치。방법회고성조사2010년1월－2014년11월경수술병리혹천자병리증실위골감염성병변환자30례림상자료，분석치료전CT평소화삼유중건도상적특점，채용GE Lightspeed 64층라선CT궤소정위상。결과30례골감염성병변환자중유13례위급성감염，점43．3％；감염환자검출병원균분별위결핵분지간균、금황색포도구균、동록가단포균급포로씨간균，분별점53．4％、40．0％、3．3％、3．3％；30례골감염성병변환자C T표현양성유병골주위출현연조직종괴、농종、골질정용골성파배、병조내출현명현사골、변연출현경화、유명현골막반응、병조내출현적기급V R성상후골질출현명현결손，양성솔분별위10．0％、60．0％、96．7％、70．0％、46．7％、36．7％、30．0％급43．3％。결론골감염성적병변적C T전형표현위변계불청초용골성적골질파배、가견명현사골형성，불동치병균소치적골감염CT변현각구특점，각충류형골감염성질병적학진수요결합병원학화병이학。
OBJECTIVE To explore the features of the CT and three‐dimensional reconstruction images for the bone infections so as to improve the value of CT scanning in the diagnosis of bone infections .METHODS From Jan 2010 to Nov 2014 ,a total of 30 patients who were confirmed as the bone infections through surgical pathology and nee‐dle biopsy were enrolled in the study ,the clinical data of the participants were retrospectively reviewed .The fea‐ture of the CT scanning and three‐dimensional reconstruction images were observed before the treatment ,and the positioned images were scanned with the use of GE Lightspeed 64‐slice spiral CT machine .RESULTS Of 30 pa‐tients with bone infections ,13 cases had acute infections ,accounting for 43 .3% .Mycobacterium tuberculosis , Staphylococcus aureus , Pseudomonas aeruginosa ,and Brucella were the isolated pathogens causing the infec‐tions ,accounting for 53 .4% ,40 .0% ,3 .3% ,and 3 .3% ,respectively .As for the CT findings of the 30 patients with bone infections ,the positive rates of the soft tissue mass ,abscess ,osteolytic destruction ,clear sequestrum in lesions ,hardened edge ,obvious periosteal reaction ,pneumatosis in lesions ,and obvious bone defects in VR image were 10 .0% ,60 .0% ,96 .7% ,70 .0% ,46 .7% ,36 .7% ,30 .0% ,and 43 .3% ,respectively .CONCLUSION The typical CT findings of the patients with bone infections include the osteolytic destruction with unclear boundary and obvious sequestrum formation .The CT findings vary in the patients with bone infections caused by different pathogens ,and the bone infections need to be confirmed in combination with etiology and pathology .