儿童胫骨远端三平面骨折CT影像学表现及诊断价值  

CT Imaging Findings the Diagnostic Value of Distal Tibial Tri-plane Fractures in Children

作　　者：马鸿杰[1] MA Hong-jie(Zhengzhou Orthopedics Hospital,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州市骨科医院,河南郑州450052

出　　处：《中国CT和MRI杂志》2019年第1期120-122,共3页Chinese Journal of CT and MRI

基　　金：河南省科技计划基金资助项目(182102310416)

摘　　要：目的探究儿童胫骨远端三平面骨折的电子计算机断层扫描(CT)表现及诊断价值。方法回顾性分析我院收治的39例胫骨远端三平面骨折患儿的影像学资料,所有患儿均行计算机X线成像(CR)正侧位、螺旋CT平扫加三维重建,比较两种检查方式对骨折分型的诊断价值。结果根据胫骨远端骨骺损伤位置,所有患儿均为外侧型;根据骨折块数目,二部分型24例,三部分型15例,无四部分型;根据骨折线是否累及关节面,I型22例,II型15例,III型2例;CR将12例三部分型诊断为二部分型,15例对关节面位置误诊或不能诊断分型;6例误诊为Salter-HarrisIII型;CT扫描对所有分型均诊断准确;随访观察无成角畸形发生。结论螺旋CT平扫结合三维重建对胫骨远端三平面骨折有较高的诊断价值,临床上可将其与CR结合为临床提供有价值的信息。Objective To explore the imaging findings and diagnostic value of computerized tomography(CT)for children with distal tibial tri-plane fractures.Methods The imaging data of 39 children with distal tibial tri-plane fractures treated in the hospital were analyzed retrospectively.All children underwent computerized radiograph(CR)positive and lateral position,spiral CT plain scan and three-dimensional reconstruction.The diagnostic value of the two examination methods for classification of fractures was compared.ResultsAccording to the location of distal tibial epiphyseal injury,all children were lateral type.According to the number of fractures,24 cases were two-part type and 15 cases were three-part type,without four-part type.According to the condition of fracture line involving the articular surface,22 cases were type I,15 cases were type II and 2 cases were type III.There were 12 cases of three-part type diagnosed as two-part type by CR.The location of articular surface in 15 cases was misdiagnosed or can not be diagnosed.6 cases were misdiagnosed as Salter-Harris type III.All types displayed by CT scan were accurate and no angulation deformity was observed during follow-up.Conclusion Spiral CT plain scan combined with three-dimensional reconstruction is of high diagnostic value for distal tibial tri-plane fractures.Clinically,it can be combined with CR to provide valuable information.

关 键 词：胫骨骨折 计算机X线成像 电子计算机断层扫描 诊断价值 

分 类 号：R814.42[医药卫生—影像医学与核医学]