DIAGNOSTIC VALUE AND EFFICIENCY OF RADIOLOGICAL IMAGING IN DIAGNOSING SPONDYLITIS
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i1.11106Keywords:
spondylitis, radiography, CT, MRI, digital tomosynthesis, specificity, sensitivity, efficiencyAbstract
The gold standard for the diagnosis of spondylitis is cultural or pathomorphological verification. However, performing interventional surgical interferences for diagnostic purposes with spondylitis have limitations. Biopsy results require careful interpretation; negative results are possible without visual navigation, important methodological problems and poor quality of the material obtained. If histological or bacteriological verification is not possible, diagnostic imaging, become the only one way for confirming the diagnosis.
The aim – to determine diagnostic value and efficiency of radiography, CT, MRI, digital tomosynthesis and their combinations in diagnosing spondylitis.
Material and Methods. Retrospective study of 140 adult patients, including 54 with tuberculous spondylitis, 41 with nonspecific and 45 – control group.
Results. The sensitivity, specificity, accuracy, predictivity and effectiveness of each of the methods, as well as combinations of MRI and CT, MRI and digital tomosynthesis are determined.
Conclusions. MRI is the best method for diagnosing spondylitis. Only MRI can detect bone marrow edema and has significant advantages in detecting the spread of the process to the spinal cord, meninges and other soft tissues. CT data best describes the differential features of the bone-destructive process and paravertebral abscesses. The combined CT+MRI increases the specificity and accuracy of diagnosis. CT increases the diagnostic capabilities of the x-ray method. From the point of view of resource efficiency and lower radiation exposure, the combination of digital tomosynthesis and MRI is promising.
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