MSCT联合血清免疫炎性因子在骨折不愈合诊断中的应用  

Application of MSCT Combined with Serum Immune Inflammatory Factors in the Diagnosis of Fracture Nonunion

作　　者：刘鹿锋 王猛 LIU Lufeng;WANG Meng(Department of Physical Education,Northwest University of Political Science and Law,Xi’an 710100,Shaanxi,P.R.China;The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,Shaanxi,P.R.China)

机构地区：[1]西北政法大学体育部,陕西西安710100 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《影像科学与光化学》2022年第5期1253-1257,共5页Imaging Science and Photochemistry

基　　金：陕西省体育局常规课题(018033)。

摘　　要：本文探究多层螺旋CT(MSCT)在膝关节损伤后骨折诊断及与血清免疫炎性因子水平相关性。选取82例疑似膝关节损伤后骨折体操运动员为研究对象,均进行X线和MSCT检查、血清免疫炎性因子检测。比较骨折愈合与未愈合患者MSCT定量参数[骨密度(BMD)、截面惯性矩力学强度指数(BSICSMI)、横截面积力学强度指数(BSICSA)]及血清免疫炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-1β]差异,分析MSCT定量参数与血清免疫炎性因子的相关性,并评价MSCT定量参数、血清免疫炎性因子对骨折不愈合评估价值。MSCT诊断膝关节损伤后骨折类型与手术结果的一致性Kappa值为0.901,符合率为92.68%;骨折愈合患者BMD、BSICSA、BSICSMI高于骨折未愈合患者,血清TNF-α、IL-6、IL-1β水平低于骨折未愈合患者(P<0.05);膝关节损伤后骨折患者BMD、BSICSA、BSICSMI与血清TNF-α、IL-6、IL-1β水平呈负相关关系(P<0.05);MSCT定量参数、血清免疫炎性因子联合评估骨折不愈合的AUC为0.908,优于各指标单独评估。MSCT诊断膝关节损伤后骨折效能较高,且定量CT参数与血清免疫炎性因子有关,MSCT联合血清免疫炎性因子可有效诊断骨折不愈合。This paper investigated the multilayer spiral CT imaging(MSCT) in the diagnosis of fractures after knee injury and its correlation with serum immune inflammatory factor levels. 82 gymnasts with suspected post-knee injury fractures were selected for the study, and all patients underwent X-ray, MSCT examination, and serum immune inflammatory factor testing. Compared the differences of quantitative parameters of MSCT [bone mineral density(BMD), cross-sectional moment of inertia mechanical strength index(BSICSMI), cross-sectional area mechanical strength index(BSICSA)] and the serum immune inflammatory factors [tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), IL-1β] between fracture healed and non-healed patients, and analyzed the correlation between the quantitative parameters of MSCT and serum immune inflammatory factors, and evaluated the value of MSCT quantitative parameters and serum immune inflammatory factors in evaluating fracture non-union. The concordance Kappa value between the type of fracture and surgical outcome after the diagnosis of knee injury by MSCT was 0.901, and the compliance rate was 92.68%.BMD,BSICSA,and BSICSMI in patients with fracture healing were higher than in patients with fracture nonunion,and serum TNF-α,IL-6,and IL-1βlevels were lower than those in patients with unhealed fractures(P<0.05).After knee injury the BMD,BSICSA,and BSICSMI were negatively correlated with serum TNF-α,IL-6,and IL-1βlevels in patients with fractures(P<0.05).The AUC of the combined assessment of quantitative parameters of MSCT and serum immune inflammatory factors for fracture nonunion was 0.908,and was better than evaluating each indicator individually.The effectiveness of MSCT in diagnosing fracture after knee injury was higher,and the quantitative CT parameters were correlated with serum immune inflammatory factors,so MSCT combined with serum immune inflammatory factors could effectively diagnose fracture nonunion.

关 键 词：多层螺旋CT 体操运动员 膝关节损伤 骨折 免疫炎性因子 

分 类 号：R683[医药卫生—骨科学] R816.8[医药卫生—外科学]