士兵胫骨应力性骨折的影像评分与临床表现相关分析  

Correlation Analysis of Imaging Score and Clinical Manifestation of Tibial Stress Fracture in Soldiers

作　　者：张秋怡 徐凯 陈凯[2] 刘忱[2] 文磊[4] ZHANG Qiu-yi;XU Kai;CHEN Kai;LIU Chen;WEN Lei(Medical imaging Institute of Xuzhou Medical University, Xuzhou 221004, China;Department of Radiology;Department of Orthopedics, No. 97 Hospital of PLA, Xuzhou 221004, China;Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China)

机构地区：[1]徐州医科大学医学影像学院,江苏徐州221004 [2]中国人民解放军第九七医院影像科,江苏徐州221004 [3]徐州医科大学附属医院影像科,江苏徐州221002 [4]中国人民解放军第九七医院骨科,江苏徐州221004

出　　处：《CT理论与应用研究（中英文）》2017年第6期783-790,共8页Computerized Tomography Theory and Applications

摘　　要：目的:明确士兵胫骨应力性骨折患者不同影像学评分与临床表现之间的相互关系,增强对士兵胫骨应力性骨折的认识。方法:本研究共纳入34例参加军事训练出现胫骨应力性骨折的士兵患者,所有对象平均年龄为19.1岁。所有患者分别由骨科医生及影像科医生采用X线、MRI扫描及CT扫描来评价胫骨应力性骨折的严重程度。同时由骨科医生对临床严重程度评分进行评价。统计学分析不同影像学检查评分与临床严重程度之间的相互关系,影像学检查评分与治愈时间之间的关系以及评价不同医生采用不同影像学设备评价患者的可靠性。结果:临床严重程度与患者的X线(r=-0.529,P=0.029)、MRI扫描(r=-0.641,P=0.006)及CT(r=-0.573,P=0.016)影像学评分存在负相关。治愈时间与患者的X线及CT影像学评分无相关性,与MRI扫描的影像学评分虽无相关性,但有相关的趋势(P=0.09)。MRI扫描的可靠性最佳(α=0.849),CT次之(α=0.779),X线第三(α=0.623)。结论:胫骨应力性骨折临床严重程度与X线、磁共振及CT扫描影像学评分存在负相关。X线、磁共振及CT扫描影像学评分与治愈时间无相关性。Objective： To investigate the relationship between severity grade for radiography, magnetic resonance （MR） imaging, and computed tomography （CT）; clinical severity; and recovery time from a tibial stress injury （TSI）, as well as to evaluate inter-assessor grading reliability. Methods： A total of 34 cases of military soldier with TSI were included and mean age of all the participants were 19.1 yrs. All the TSI patients were evaluated by X-ray, MR imaging and CT by an orthopedist and a radiologist for the imaging severity. The clinical severity of these patients were assessed with an orthopedist. Statistical analyses were employed to explore the relationship between severity grade for radiography, magnetic resonance （MR） imaging, and computed tomography （CT）; clinical severity; and recovery time from a tibial stress injury （TSI）, as well as to evaluate inter-assessor grading reliability. Results： Negative associations could be found between X-ray （r =-0.529, P = 0.029）, MR imaging （r=-0.641, P= 0.006）, CT （r=-0.573, P= 0.016） and clinical severity. No correlation was found between by X-ray, CT and recovery time. A correlation trend was found between MRI and recovery time （P = 0.09）. The best reliability was MRI （a = 0.849）, second was CT （a --- 0.779） and third was X ray （a = 0.623）. Conclusions： The clinical severity of TSI was negative associated with X-ray, MR imaging and CT grade score. No correlation was found between recovery time and with X-ray, MR imaging and CT grade score.

关 键 词：应力性骨折 影像学评分 临床严重评分 相关性 

分 类 号：R816.8[医药卫生—放射医学] R82[医药卫生—临床医学]