多层螺旋CT多平面重建联合X射线摄影在股骨颈骨折中的诊断价值  

Diagnostic value of multi-slice spiral CT MPR combined with X-ray radiography on the fracture of femoral neck

作　　者：苏奇 杜磊磊[2] 侯波[1] 苏玉光 刘启学 司成双 SU Qi;DU Lei-lei;HOU Bo(Department of Radiology,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,China;不详)

机构地区：[1]秦皇岛市中医医院放射科,河北秦皇岛066000 [2]河间市人民医院骨外科,河北河间062450

出　　处：《中国医学装备》2023年第3期45-49,共5页China Medical Equipment

基　　金：河北省医学科学研究课题计划(20211091)“多层螺旋CT在股骨转子间骨折患者中的诊断价值研究”。

摘　　要：目的:探究多层螺旋CT多平面重建(MPR)联合X射线摄影在股骨颈骨折中的诊断价值。方法:选取医院收治的108例疑似股骨颈骨折的患者,分别采用多层螺旋CT MPR、X射线摄影及两种方式联合对患者进行检查,比较3种检查方法对股骨颈骨折的诊断效能。结果:经临床诊断,108例疑似股骨颈骨折患者中,98例为阳性,10例为阴性。多层螺旋CT MPR联合X射线摄影检查对股骨颈骨折的解剖分型诊断(头下型、头颈型、基底型及正常)的检出率均高于多层螺旋CT MPR及X射线摄影单项诊断,差异具有统计学意义(χ^(2)=4.267,χ^(2)=3.905,χ^(2)=5.357,χ^(2)=6.667;P<0.05);多层螺旋CT MPR联合X射线摄影对股骨颈骨折的Garden分型诊断Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型及正常的检出率高于多层螺旋CT MPR及X射线摄影单项诊断,差异具有统计学意义(χ^(2)=5.594,χ^(2)=3.981,χ^(2)=4.985,χ^(2)=4.378,χ^(2)=6.667;P<0.05);多层螺旋CT MPR联合X射线技术对股骨颈骨折的阳性率、阴性率以及检出率均高于多层螺旋CT MPR、X射线摄影单项诊断,差异具有统计学意义(χ^(2)=8.151,χ^(2)=6.667,χ^(2)=12.956;P<0.05)。受试者工作特征(ROC)曲线分析显示,多层螺旋CT MPR联合X射线摄影对股骨颈骨折的诊断价值高于多层螺旋CT MPR及X射线摄影单项诊断,ROC曲线下面积(AUC)分别为0.756、0.782和0.813。结论:使用多层螺旋CT MPR与X射线摄影联合检测,能够提高临床诊断价值,可用于对股骨颈骨折的诊断。Objective:To explore the diagnostic value of multi-slice helical computed tomography(CT)multi-planner reformation(MPR)combined with X-ray radiography on the fracture of femoral neck.Methods:108 patients with suspected fracture of femoral neck admitted to hospital were selected,and multi-slice spiral CT MPR,X-ray and the combination of the two methods were respectively used to examine the patients with fracture of femoral neck.And then,the diagnostic performances of three kinds of examination methods for the fracture of femoral neck were compared.Results:In 108 patients with suspected fracture of femoral neck,98 were positive and 10 were negative as the clinical diagnosis.The detection rate of the diagnosis of anatomical classification of the fracture of femoral neck(below femoral head type,head and neck type,basal type and normal type)of the combined examination of multi-slice spiral CT MPR and X-ray was significantly higher than that of single multi-slice spiral CT MPR diagnosis and single X-ray diagnosis,and the differences were statistically significant(χ^(2)=4.267,χ^(2)=3.905,χ^(2)=5.357,χ^(2)=6.667,P<0.05),respectively.The detection rate of Garden classification diagnosis(type Ⅰ,type Ⅱ,type Ⅲ,type Ⅳ and normal)of multislice spiral CT MPR combined with X-ray for fracture of femoral neck were higher than those of single multi-slice spiral CT MPR and single X-ray,and the differences were statistically significant(χ^(2)=5.594,χ^(2)=3.981,χ^(2)=4.985,χ^(2)=4.378,χ^(2)=6.667,P<0.05),respectively.The positive,negative and detection rates of multi-slice spiral CT MPR combined with X-ray for fracture of femoral neck were significantly higher than those of single multi-slice spiral CT MPR and single X-ray(χ^(2)=8.151,χ^(2)=6.667,χ^(2)=12.956,P<0.05),respectively.The analysis of receiver operating characteristic(ROC)curve showed that the diagnostic value of multi-slice spiral CT MPR combined with X-ray was higher than that of single multi-slice spiral CT and single X-ray in the diagnosis of fracture

关 键 词：多层螺旋CT 多平面重建(MPR) X射线摄影 股骨颈骨折 诊断价值 

分 类 号：R816.8[医药卫生—放射医学]