MSCT三维重建技术对老年股骨颈骨折患者临床应用价值研究  

Clinical Application Value of MSCT Three-Dimensional Reconstruction Technology in Elderly Patients with Femoral Neck Fractures

作　　者：史纪元[1] 刘慧通[1] 武世勋[1] 王涛[1] 傅蔷 SHI Ji-yuan;LIU Hui-tong;WU Shi-xun;WANG Tao;FU Qiang(Department of Orthopedics,Shaanxi Provincial People's Hospital,Xi'an 710068,Shaanxi Province,China;Department of Hematology and Oncology,Xi'an Children's Hospital,Xi'an 710004,Shaanxi Province,China)

机构地区：[1]陕西省人民医院骨科,陕西西安710068 [2]西安市儿童医院血液肿瘤科,陕西西安710004

出　　处：《中国CT和MRI杂志》2022年第3期171-173,共3页Chinese Journal of CT and MRI

基　　金：陕西省重点研发计划-一般项目-社会发展领域(2017SF-259)。

摘　　要：目的研究多层螺旋CT(MSCT)三维重建技术对老年股骨颈骨折患者临床应用价值。方法选取本院2017年4月至2018年6月收治且经手术或病理诊断确诊的82例股骨颈骨折患者作为研究对象。根据不同检查方式分为X线组和MSCT组。比较不同检查诊断股骨颈骨折Garden分型的符合率;术后对两组患者进行1年随访,比较其预后情况及骨折不愈合与股骨头坏死等情况。结果X线检查结果显示,Garden分型中Ⅰ型1例,Ⅱ型6例,Ⅲ型14例,Ⅳ型12例,共5例与手术病理评估不一致,诊断符合率为84.85%。MSCT检查结果提示,Garden分型中Ⅰ型2例,Ⅱ型16例,Ⅲ型31例,共1例与手术病理评估不一致,诊断符合率为97.96%,MSCT诊断符合率显著高于X线(P<0.05);X线组术后1年骨折不愈合和股骨头坏死发生率显著高于MSCT组(P<0.05)。结论在诊断老年股骨颈骨折患者分型、治疗方案选择及预后评估中,相比X线平片,MSCT三维重建可取得明显更佳的诊断效果,可指导临床手术方案制定。Objective To study the clinical application value of multi-slice spiral CT(MSCT)three-dimensional reconstruction technology in elderly patients with femoral neck fractures.Methods 82 patients with femoral neck fractures admitted to our hospital from April 2017 to June 2018 and confirmed by surgery or pathological diagnosis were selected as the research subjects.According to different examination methods,they are divided into X-ray group and MSCT group.The accuracy of different examinations in the diagnosis of Garden classification of femoral neck fractures was compared.The patients in the two groups were followed up for 1 year after operation,and their prognosis,nonunion and femoral head necrosis were compared.Results X-ray examination results showed that in the Garden classification,there were 1 case in type I,6 cases in typeⅡ,14 cases in typeⅢ,and 12 cases in typeⅣ.5 cases in total were inconsistent with the surgical pathological evaluation.And the diagnostic accuracy was 84.85%.The MSCT results showed that in the Garden classification,there were 2 case in type I,16 cases in typeⅡ,31 cases in typeⅢ,and 12 cases in typeⅣ,1 cases in total were inconsistent with the surgical pathological evaluation.And the diagnostic accuracy was 97.96%.The diagnostic accuracy of MSCT was significantly higher than that of X-rays(P<0.05).The incidence of nonunion and femoral head necrosis in 1 year after operation in the X-ray group was significantly higher than that in the MSCT group(P<0.05).Conclusion In the diagnosis of classification of femoral neck fracture of elderly patients,selecting of treatment,and prognostic evaluation,compared to X-ray,MSCT 3D reconstruction can achieve significantly better diagnostic effects and can guide the formulation of clinical surgical plans.

关 键 词：多层螺旋CT 股骨颈骨折 三维重建技术 临床应用价值 

分 类 号：R274.1[医药卫生—中医骨伤科学] R445.3[医药卫生—中医学]