64层螺旋CT诊断膝关节创伤后隐匿病变及软组织损伤价值探究  

Value of 64 Slice Spiral CT in the Diagnosis of Occult Lesions and Soft Tissue Injury after Knee Trauma

作　　者：宋晓飞[1] 张长成[1] 李振武[1] 陈波 张保龙 SONG Xiao-fei;ZHANG Zhang-cheng;LI Zhen-wu(Department of Orthopedics,The Central Hospital of Nanyang City,Nanyang 473000,Henan Province,China)

机构地区：[1]河南省南阳市中心医院骨二科,河南南阳473000 [2]河南省南阳市中心医院CT室,河南南阳473000 [3]河南省郑州市人民医院骨三科,河南郑州450000

出　　处：《中国CT和MRI杂志》2017年第12期140-143,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨64层螺旋CT诊断膝关节创伤后隐匿病变及软组织损伤的临床价值。方法以我院诊治的膝关节创伤患者100例为研究对象,均行X线、64层螺旋CT检查,其中X线疑为胫骨平台骨折病例55例,比较两种方法对膝关节胫骨平台骨折的诊断效能,并对比X线、64层螺旋CT对各型胫骨平台骨折检出率,分析两种检查方法下骨折塌陷程度、水平错位显示程度及影像学特点。结果本组100例膝关节创伤患者中55例疑为胫骨平台骨折,占55.00%;64层螺旋CT诊断胫骨平台骨折的灵敏度80.00%、准确度70.00%明显高于X线60.00%(P<0.05),而特异度78.18%、60.00%比较差异无统计学意义(P>0.05);64层螺旋CT对Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ型胫骨平台骨折的检出率略高于X线,对Ⅰ-Ⅵ型的总检出率86.67%明显高于X线60.00%(P<0.05);64层螺旋CT对骨折塌陷程度、水平错位程度检出率(42.22%、48.89%)高于X线(17.78%、13.33%)(P<0.05);64层螺旋CT对胫骨平台骨折隐匿病变、软组织损伤的显示较X线好。结论与X线相比,64层螺旋CT在膝关节骨折辅助诊断中更有优势,通过多平面、多角度成像更好显示创伤后隐匿病变及软组织损伤,提高诊断灵敏度、准确度,有较高推广价值。Objective To study the clinical value of 64 slice spiral CT in the diagnosis of occult lesions and soft tissue injury after knee trauma.Methods A total of 100 patients with knee trauma treated in the hospital from April 2015 to July 2017 were selected as study subjects.All patients were examined with X-ray and 64 slice spiral CT,and X-ray diagnosed 55 patients with suspected tibial plateau fractures.The diagnostic efficiencies were compared between the two methods for tibial plateau fractures.The detection rates of tibial plateau fractures were compared between X-ray and 64 slice spiral CT.The display and imaging findings of the two examination methods for collapse degree of fractures and horizontal dislocation were analyzed.Results Of 100 patients with knee trauma,55 patients had suspected tibial plateau fractures,accounting for 55.00%.The sensitivity and accuracy of 64 slice spiral CT in the diagnosis of tibial plateau fractures(80.00%,70.00%)were significantly higher than those of X-ray(60.00%,60.00%)(P<0.05),while the specificity showed no significant difference between the two methods(78.18%vs 60.00%)(P>0.05).The detection rates of 64 slice spiral CT in type I,II,III,IV,V and VI tibial plateau fractures were slightly higher than those of X-ray,and total detection rate(86.67%)was significantly higher than that of X-ray(60.00%)(P<0.05).The detection rates of the collapse degree of fractures and horizontal dislocation by 64 slice spiral CT(42.22%,48.89%)were higher than those of X-ray(17.78%,13.33%)(P<0.05).64 slice spiral CT was superior to X-ray in the display of occult lesions and soft tissue injury in tibial plateau fractures.Conclusion 64 slice spiral CT has more advantages over X-ray in the diagnosis of knee joint fractures.It can well display post-traumatic occult lesions and soft tissue injury through multi-plane and multi-angle imaging,and improve the diagnostic sensitivity and accuracy.

关 键 词：64层螺旋CT 膝关节创伤 隐匿病变 软组织损伤 

分 类 号：R683.42[医药卫生—骨科学] R814.42[医药卫生—外科学]