MRI和CT在胫骨平台隐匿性骨折三柱分型诊断中的应用价值  

Value of MRI and CT in the diagnosis of three column classification of occulted tibial plateau fractures

作　　者：孙毅[1] 耿磊[1] 赵妍[1] 朱志韬 张苏波[1] 徐永军[1] 丁军明[1] Sun Yi;Geng Lei;Zhao Yan;Zhu Zhitao;Zhang Subo;Xu Yongjun;Ding Junming(Department of Imaging,the Second People’s Hospital of Lianyungang,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市第二人民医院影像科,222000

出　　处：《中国实用医刊》2021年第15期1-4,共4页Chinese Journal of Practical Medicine

基　　金：连云港市卫生计生科技项目(201716)。

摘　　要：目的探究磁共振成像(MRI)和CT在胫骨平台隐匿性骨折三柱分型诊断中的应用价值。方法抽取2018年9月至2019年12月连云港市第二人民医院收治的临床高度怀疑胫骨平台骨折的患者78例,均给予MRI和CT检查,并予以三柱分型。以随访结果为金标准,分析MRI、CT及联合检查诊断胫骨平台隐匿性骨折的准确率、灵敏度、特异度及一致率。结果 MRI检查诊断出胫骨平台隐匿性骨折54例,CT检查诊出52例,MRI联合CT诊出56例。MRI单独诊断胫骨平台隐匿性骨折的特异度、灵敏度及准确率与CT比较差异未见统计学意义(P>0.05),MRI联合CT诊断骨折的准确率高于MRI及CT单一检测(P<0.05)。MRI诊断骨折累及关节面的敏感度(98.22%)高于CT(95.77%),特异度(88.32%)低于CT(96.21%),差异有统计学意义(P<0.05);但两者准确率比较差异未见统计学意义(P>0.05)。MRI进行三柱分型诊断的符合率高于CT,差异有统计学意义(P<0.05)。结论 MRI在诊断基于三柱分型的胫骨平台隐匿性骨折一致率高于CT诊断,但对累及关节面骨折其诊断存在高估风险,对临床诊疗具有良好的辅助作用。Objective To investigate the value of magnetic resonance imaging(MRI)and computed tomography(CT)in the diagnosis of three column classification of occulted tibial plateau fractures.Methods A total of 78 patients with clinically highly suspected tibial plateau fracture admitted to the Second People’s Hospital of Lianyungang from September 2018 to December 2019 were selected.And all selected patients underwent MRI and CT examinations,and the fractures were typed according to three column classification.The accuracy rate,sensitivity,specificity and consistent rate of MRI,CT,and combination of them were analyzed,with the following up results as gold standard.Results MRI detected 54 cases of occulted tibial plateau fractures,CT examination detected 52 cases of occulted tibial plateau fractures,and MRI combined with CT detected 56 cases of occulted tibial plateau fractures.There was no significant difference in specificity,sensitivity,or accuracy rate between MRI and CT in the diagnosis of occulted tibial plateau fractures(P>0.05).MRI combined with CT had a higher accuracy rate than single MRI and single CT in the diagnosis of occulted tibial plateau fractures(P<0.05).In the diagnosis of fractures involving the articular surface,the sensitivity of MRI(98.22%)was higher than that of CT(95.77%),and the specificity of MRI(88.32%)was lower than that of CT(96.21%),P<0.05;however,there was no significant difference in accuracy rate between MRI and CT(P>0.05).MRI has a higher consistent rate than CT in three column classification of occulted tibial plateau fractures(P<0.05).Conclusions MRI has a higher consistent rate than CT in the diagnosis of occulted tibial plateau fractures based on three-column classification,but it has high risk in the diagnosis of involved articular surface fractures.MRI has a good auxiliary role in clinical diagnosis and treatment.

关 键 词：胫骨平台 隐匿性骨折 影像诊断 三柱分型 

分 类 号：R445.2[医药卫生—影像医学与核医学] R816.8[医药卫生—诊断学] R683.42[医药卫生—临床医学]