螺旋CT三维重建技术用于AO-C型桡骨远端骨折的诊断价值  

Diagnostic value of three-dimensional spiral CT reconstructions in AO C-type fractures of the distal radius

作　　者：宋彬略 周童飞 梁辉 谢秉局[4] Song Binlue;Zhou Tongfei;Liang Hui;Xie Bingju(Department of Radiology,Ruian Hospital of Traditional Chinese Medicine,Ruian 325200,Zhejiang Province,China;Department of Orthopedics and Traumatology,Ruian Hospital of Traditional Chinese Medicine,Ruian 325200,Zhejiang Province,China;Department of Information,Ruian Hospital of Rraditional Chinese Medicine,Ruian 325200,Zhejiang Province,China;Department of Orthopedics,Ruian People's Hospital,Ruian 325200,Zhejiang Province,China)

机构地区：[1]瑞安市中医院放射科,浙江省325200 [2]瑞安市中医院骨伤科,浙江省325200 [3]瑞安市中医院信息科,浙江省325200 [4]瑞安市人民医院骨科,浙江省325200

出　　处：《中国基层医药》2021年第2期258-262,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨多层螺旋CT三维重建技术诊断AO-C型桡骨远端骨折的临床应用价值。方法选取2018年3月至2020年3月瑞安市中医院急诊收治的经手术确认的AO-C型桡骨远端骨折患者136例为研究对象,所有研究对象术前进行X线检测和多层螺旋CT三维重建检测,观察两种检测方法对于骨折创面呈现的影像学参数情况差异,比较两种检测方法对AO-C型桡骨远端骨折的诊断符合率。结果螺旋CT三维重建检测AO-C型桡骨远端骨折所观察到的创伤骨块数量485块,显著多于X线检测的325块,且检测到的矢状面骨折移位距离[(2.98±0.62)mm]和冠状面腕关节塌陷距离[(1.74±0.49)mm],显著高于X线检测的(1.51±0.47)mm和(0.98±0.31)mm(χ^(2)=4.931,t=5.884、6.375,均P<0.001);螺旋CT三维重建检测对AO-C型桡骨远端骨折总体诊断符合率(97.79%)显著高于X线检测(84.56%)(χ^(2)=14.806,P<0.001),且螺旋CT三维重建检测对AO-C1型和AO-C2型桡骨远端骨折诊断符合率(98.36%和95.35%)显著高于X线检测(83.61%和79.07%)(χ^(2)=8.093、5.878,P=0.004、0.015)。结论较X线检测,螺旋CT三维重建检测可更全面和清晰地呈现桡骨远端关节内骨折情况,提高诊断分型符合率,避免漏诊和误诊。Objective To investigate the clinical value of multi-slice three-dimensional spiral CT reconstructions in AO C-type fractures of the distal radius.Methods A total of 136 patients with surgically confirmed AO C-type fractures of the distal radius who received treatment in Ruian People's Hospital from March 2018 to March 2020 were included in this study.Prior to surgery,all patients underwent X-ray imaging and multi-slice three-dimensional spiral CT reconstructions in AO C-type fractures of the distal radius.The differences in imaging parameters of fractured surface between these two examination methods were determined.The coincidence rate in identifying AO C-type fractures of the distal radius was compared between X-ray imaging and multi-slice three-dimensional spiral CT reconstructions.Results The number of traumatic bone blocks identified by three-dimensional spiral CT reconstructions was significantly higher than that identified by X-ray imaging(485 vs.325).Moreover,sagittal fracture displacement distance[(2.98±0.62)mm]and coronal wrist collapse distance[(1.74±0.49)mm]identified by three-dimensional spiral CT reconstructions were significantly greater than those detected by X-ray imaging[(1.51±0.47)mm and(0.98±0.31)mm,χ^(2)=4.931,t=5.884,6.375,all P<0.01].The overall coincidence rate of three-dimensional spiral CT reconstructions in identifying AO C-type fractures of the distal radius was significantly greater than that of X-ray imaging(97.79%vs.84.56%,χ^(2)=14.806,P<0.001).The coincidence rate of three-dimensional spiral CT reconstructions in identifying AO C1-type and AO C2-type fractures of the distal radius was significantly greater than that of X-ray imaging[AO C1-type:98.36%vs.83.61%,χ^(2)=8.093,P=0.004;AO C2-type:95.35%vs.79.07%,5.878,P=0.015].Conclusion Compared with X-ray imaging,three-dimensional spiral CT reconstructions can more comprehensively and clearly display the situation of intra-articular fracture of the distal radius,exhibit higher coincidence rate in the identification of fracture t

关 键 词：桡骨骨折 成像 三维 体层摄影术 螺旋计算机 关节内骨折 诊断符合率 临床价值 

分 类 号：R687.3[医药卫生—骨科学] R816.8[医药卫生—外科学]