MRI、MSCT对腕关节隐匿性骨折的诊断价值  

Diagnostic value of MRI and MSCT in occult wrist fracture

作　　者：王谦 杨宝军[1] 王明利[1] 刘文涛[1] 陈丽丽 胡剑非 WANG Qian;YANG Baojun;WANG Mingli;LIU Wentao;CHEN Lili;HU Jianfei(CT Room,Baoji Hospital of Traditional Chinese Medicine,Baoji 721000,China)

机构地区：[1]宝鸡市中医医院CT室,陕西宝鸡721000

出　　处：《临床医学研究与实践》2022年第8期117-120,124,共5页Clinical Research and Practice

摘　　要：目的比较磁共振成像(MRI)与多层螺旋CT(MSCT)对腕关节隐匿性骨折的诊断价值。方法回顾性选取2019年1月至2021年3月在我院诊治的83例疑似腕关节隐匿性骨折患者作为研究对象,均行MRI、MSCT检查。分析MRI、MSCT对腕关节隐匿性骨折的诊断结果及其与手术结果的一致性;以手术结果为金标准,比较MRI、MSCT对腕关节隐匿性骨折的诊断效能;比较MRI、MSCT对腕关节隐匿性骨折的检出情况;比较MRI、MSCT对不同部位腕关节隐匿性骨折的诊断准确度。结果手术结果显示,83例患者中有74例确诊为腕关节隐匿性骨折,占89.16%。Kappa检验结果显示,MRI诊断结果与手术结果的一致性极强,Kappa值为0.875;MSCT诊断结果与手术结果的一致性较弱,Kappa值为0.311。以手术结果为金标准,MRI对腕关节隐匿性骨折的诊断准确度、灵敏度、阴性预测值分别为97.59%、98.65%、88.89%,高于MSCT的79.52%、81.08%、30.00%(P<0.05);MRI对腕关节隐匿性骨折的诊断特异度、阳性预测值分别为88.89%、98.65%,与MSCT的66.67%、95.24%比较,差异无统计学意义(P>0.05)。MRI、MSCT诊断腕关节隐匿性骨折的误诊率比较,差异无统计学意义(P>0.05);MRI诊断腕关节隐匿性骨折的符合率高于MSCT,漏诊率低于MSCT(P<0.05)。手术结果显示,74例腕关节隐匿性骨折中,骨折部位为小多角骨4例(5.41%)、腕骨55例(74.32%)、长干骨15例(20.27%);MRI检查结果显示,骨折部位为小多角骨4例、腕骨54例、长干骨15例;MSCT检查结果显示,骨折部位为小多角骨4例、腕骨43例、长干骨13例。MRI、MSCT对小多角骨、腕骨、长干骨骨折的诊断准确度比较,差异无统计学意义(χ^(2)=0.000、1.912、0.065,P=1.000、0.167、0.799)。结论MRI对腕关节隐匿性骨折的诊断准确度、灵敏度、阴性预测值均高于MSCT,与手术结果具有高度一致性。Objective To compare the diagnostic value of magnetic resonance imaging(MRI)and multi-slice spiral CT(MSCT)in occult wrist fracture.Methods A total of 83 patients with suspected occult wrist fracture diagnosed and treated in our hospital from January 2019 to March 2021 were retrospectively selected as the research objects,and all patients underwent MRI and MSCT examination.The diagnostic results of MRI and MSCT in occult wrist fracture and its consistency with the surgical results were analyzed;taking the surgical results as the gold standard,the diagnostic efficacy of MRI and MSCT in occult wrist fracture was compared;the detection condition of MRI and MSCT in occult wrist fracture was compared;the accuracy of MRI and MSCT in the diagnosis of occult wrist fracture of different parts was compared.Results The surgical results showed that 74 of the 83 patients were diagnosed as occult wrist fracture,accounting for 89.16%.Kappa test results showed that the MRI diagnostic result was highly consistent with the surgical result,and the Kappa value was 0.875;the MSCT diagnostic result was weak consistent with the surgical result,and the Kappa value was 0.311.Taking the surgical results as the gold standard,the accuracy,sensitivity and negative predictive value of MRI in the diagnosis of occult wrist fracture were 97.59%,98.65%and 88.89%respectively,which were higher than 79.52%,81.08%and 30.00%of MSCT(P<0.05);the specificity and positive predictive value of MRI in the diagnosis of occult wrist fracture were 88.89%and 98.65%respectively,there were no significant differences compared with 66.67%and 95.24%of MSCT(P>0.05).There was no significant difference in the misdiagnosis rate between MRI and MSCT in the diagnosis of occult wrist fracture(P>0.05);the coincidence rate of MRI in the diagnosis of occult wrist fracture was higher than that of MSCT,and the missed diagnosis rate was lower than that of MSCT(P<0.05).The surgical results showed that among the 74 cases of occult wrist fracture,the fracture sites were trapezoid bo

关 键 词：核磁共振成像 多层螺旋CT 腕关节隐匿性骨折 

分 类 号：R445.2[医药卫生—影像医学与核医学]