MSCT重建技术在诊断儿童外伤性细微骨折中的临床应用价值  

Clinical Application Value of MSCT Reconstruction in the Diagnosis of Traumatic Microfracture in Children

作　　者：宋得夫[1] 彭涛[1] 张磊[1] 马玉龙[1] 王小玮[1] SONG De-fu;PENG Tao;ZHANG Lei(Department of Orthopedics,Xi'an Children's Hospital,Xi'an 710003,Shaanxi Province,China)

机构地区：[1]西安市儿童医院骨科,陕西西安710003

出　　处：《中国CT和MRI杂志》2020年第12期161-163,174,共4页Chinese Journal of CT and MRI

基　　金：陕西省社会发展科技攻关项目(2015SF061)。

摘　　要：目的旨在探讨MSCT重建技术在诊断儿童外伤性细微骨折中的临床应用价值。方法选取我院2017年5月~2018年12月收治的怀疑骨折患者88例,对88例患者进行MSCT、X线检查,并以病理学检查结果为标准,分析MDCT、X线检查的阳性检出率,比较误诊、漏诊率。结果进行MSCT扫描重建后显示有80例患者有骨折,阳性率为90.90%;X线检查后有67例患者有骨折,阳性率为76.13%(P<0.05);病理结果表明在88例疑似骨折患者中共有86例患者存在骨折现象,胫骨平台骨折MSCT存在3例误诊、漏诊情况,X线存在6例误诊、漏诊情况;髋关节骨折MSCT存在2例误诊、漏诊情况,X线存在3例误诊、漏诊情况;肋骨骨折,X线存在2例误诊、漏诊情况;眼眶骨折,X线存在2例误诊、漏诊情况;跟骨骨折,MSCT存在1例误诊、漏诊情况,X线存在3例误诊、漏诊情况;脊柱骨折,X线存在3例误诊、漏诊。MSCT共存在6例误诊、漏诊,X线存在19例误诊、漏诊(P<0.05)。结论联合应用MSCT扫描及重建技术可对细微骨折的检出率有效提高,明显减少误诊、漏诊率,为临床对骨折严重程度的判断及治疗方案的确定提供可靠依据。Objective To explore the clinical application value of MSCT reconstruction in the diagnosis of traumatic microfracture in children.Methods 88 patients with suspected fractures admitted to our hospital from May 2017 to December 2018 were selected.88 patients underwent MSCT and X-ray examination.The results of the pathological examination were used as a standard to analyze the positive detection rate of MDCT and X-ray examination,and to compare the rate of misdiagnosis and missed diagnosis.Results MSCT reconstruction showed that 80 patients had fractures,the positive rate was 90.90%,68 patients had fractures after X-ray examination,the positive rate was 76.31%(P<0.05),and pathological results showed that 86 patients in 88 patients with suspected fractures had fracture.There were 3 cases with misdiagnosis and missed diagnosis of MSCT for fracture of tibial plateau.There were 6 cases with misdiagnosis and missed diagnosis of X-ray.There were 2 cases with misdiagnosis and missed diagnosis of MSCT for fracture of hip joint.There were 3 cases with misdiagnosis and missed diagnosis of X-ray.There were 2 cases with misdiagnosis and missed diagnosis of X-ray for rib fracture.There were 2 cases with misdiagnosis and missed diagnosis of X-ray for orbital fracture.There were 3 cases with misdiagnosis and missed diagnosis of MSCT for calcaneal fractures,and 3 cases with misdiagnosis and missed diagnosis of X-ray.There were 3 cases with misdiagnosis and missed diagnosis of X-ray for spinal fracture.There were 6 cases with misdiagnosis and missed diagnosis in MSCT in total.There were 19 cases with misdiagnosis and missed diagnosis in X-ray in total(P<0.05).Conclusion The combined application of MSCT scanning and reconstruction technology can effectively improve the detection rate of microfractures,significantly reduce the rate of misdiagnosis and missed diagnosis,and provide a reliable basis for judging the severity of fractures and the choice of treatment options.

关 键 词：MSCT重建技术 外伤性细微骨折 临床价值 

分 类 号：R445.3[医药卫生—影像医学与核医学] R683[医药卫生—诊断学]