踝关节细微骨折应用容积重建和螺旋CT多平面的临床研究  

Clinical study on the application of VR and spiral CT multi-planar in ankle tiny fracture

作　　者：蒋佶廷 郭琼 何西西 周丹丹 高勒 JIANG Ji-ting;GUO Qiong;HE Xi-xi(Radiology Department,Guang'an People's Hospital,Guang'an 638000,China;不详)

机构地区：[1]广安市人民医院放射科,四川广安638000 [2]成都市第三人民医院放射科,四川成都610000

出　　处：《中国医学装备》2021年第5期65-68,共4页China Medical Equipment

基　　金：四川省卫生和计划生育委员会科研课题(16PJ048)“X线平片、CT及MRI联合应用对青少年脊柱侧弯治疗方案的选择及改进的价值研究”。

摘　　要：目的:探讨螺旋CT多平面重建(MPR)和容积重建(VR)在踝关节细微骨折中的临床诊断价值。方法:选取医院收治的42例疑似踝部及足部外伤患者,分别采用X射线片、螺旋CT MPR和VR对所有患者进行检查,观察3种方法踝关节细微骨折的检出情况,对比分析X射线片与螺旋CT对踝关节细微骨折检出的灵敏度、特异度和准确率。结果:临床确诊为踝关节细微骨折37例,螺旋CT的诊断准确率为92.86%(39/42),明显高于X射线片的57.14%(24/42);螺旋CT的灵敏度、特异度、阳性预测值和阴性预测值分别为94.59%、80.00%、97.22%和66.67%,明显高于X射线片的65.71%、14.29%、79.31%和7.69%,差异均有统计学意义(χ^(2)=9.577,χ^(2)=5.182,χ^(2)=5.363,χ^(2)=7.363;P<0.05)。37例踝关节细微骨折患者临床诊断出踝关节损伤、跗骨骨折、跖骨骨折及关节脱位分别为22例(64处)、20例(27处)、3例(8处)和8例(8处);各部位细微骨折总检出率MPR为95.33%,明显高于VR的87.85%、X射线片的79.44%(χ^(2)=3.882,χ^(2)=12.249;P<0.05)。MPR对踝关节损伤的检出率为100.00%,明显高于VR的89.06%、X射线片的82.81%,差异均有统计学意义(χ^(2)=7.405,χ^(2)=12.034;P<0.05);MPR对跗骨骨折的检出率为100.00%,明显高于X射线片的74.07%,差异均有统计学意义(χ^(2)=8.043,P<0.05)。结论:螺旋CT对踝关节细微骨折的诊断性较高,MPR对踝关节细微骨折的检出情况高于VR。Objective:To explore the clinically diagnostic value of multi-planar reconstruction(MPR)and volume rendering(VR)of spiral computed tomography(CT)in ankle tiny fractures.Methods:42 patients with suspected ankle and foot trauma admitted to the hospital were selected.All the patients were examined by X-ray film,spiral CT MPR and VR,respectively.The detections of three methods on ankle tiny fracture were observed,and the sensitivity,specificity and accuracy of the detection of tiny fractures of ankle joint between X-ray film and spiral CT were compared and analyzed.Results:37 cases of them were confirmed as ankle tiny joint by clinical diagnosis,and the diagnostic accuracy of spiral CT was 92.86%(39/42),which was significantly higher than 57.14%(24/42)of X-ray film.The sensitivity,specificity,positive and negative prediction value of spiral CT were 94.59%,80.00%,97.22%,and 66.67%,respectively,which were significantly higher than 65.71%,14.29%,79.31%and 7.69%of X-ray films,and the differences of them between the two methods were statistically significant(χ^(2)=9.577,χ^(2)=5.182,χ^(2)=5.363,χ^(2)=7.363,P<0.05).In 37 cases with tiny fracture of ankle joint,the confirmed injury of ankle joint,tarsal fracture,metatarsal fracture and joint dislocation were 22 cases(64 locations),20 cases(27 locations),3 cases(8 locations)and 8 cases(8 location),respectively.The total detection rate of tiny fractures in various parts of MPR was 95.33%,which was significantly higher than 87.85%of VR and 79.44%of X-ray film(χ^(2)=3.882,χ^(2)=12.249,P<0.05).The detection rate of MPR on the injury of ankle joint was 100.00%,which was significantly higher than 89.06%of VR and 82.81%of X-ray film,and the differences was statistically significant(χ^(2)=7.405,χ^(2)=12.034,P<0.05).The detection rate of MPR on tarsal fractures was 100.00%,which was significantly higher than 74.07%of X-ray films,and the differences were statistically significant(χ^(2)=8.043,P<0.05).Conclusion:Spiral CT has higher diagnosis effect on ankle tiny fractures,and t

关 键 词：螺旋CT 多平面重建 容积重建 X射线片 踝关节细微骨折 

分 类 号：R816.8[医药卫生—放射医学]