外伤性砧镫关节脱位的CT诊断与手术符合率对比分析  

Comparative analysis of coincidence rate of HRCT diagnosis and surgical diagnosis of traumatic dislocation of anvil sta⁃pes joint

作　　者：徐重阳[1] 李鸿真 朱传锋 张秀丽 刘从涛 XU Chongyang;LI Hongzhen;ZHU Chuanfeng;ZHANG Xiuli;LIU Congtao(Department of Radiology,Huaiyin People's Hospital,Jinan 250021,China;Department of Anesthesiology,Shandong Second Provincial General Hospital,Jinan 250022,China;Department of Imaging,Feicheng Traditional Chinese Medicine Hospital,Taian 271600,China;Department of Imaging,Chiping District Second People's Hospital,Liaocheng 252100,China;Department of Imaging Center,Shandong Second Provincial General Hospital,Jinan 250022,China)

机构地区：[1]山东省济南市槐荫人民医院放射科,山东济南250021 [2]山东省第二人民医院麻醉科,山东济南250022 [3]山东省泰安市肥城市中医医院影像科,山东泰安271600 [4]山东省聊城市茌平区第二人民医院影像科,山东聊城252100 [5]山东省第二人民医院影像中心,山东济南250022

出　　处：《医学影像学杂志》2024年第5期34-37,共4页Journal of Medical Imaging

摘　　要：目的探讨外伤性砧镫关节脱位的HRCT特点。方法选取经手术证实外伤性砧镫关节脱位的14例患者资料,对CT原始图像及常规轴位和三维重建图像进行分析,观察砧镫关节脱位及砧骨、镫骨损伤,与术中诊断结果对照。结果CT诊断砧镫关节分离7例,术中诊断9例,诊断准确率77.78%;复杂的砧镫关节脱位CT诊断3例,手术发现5例,诊断准确率60.00%;砧骨脱位CT诊断4例,手术发现7例,诊断准确率57.14%;镫骨脱位CT诊断0例,手术发现1例;砧骨及镫骨骨折CT诊断2例,手术发现4例,诊断准确率50.00%。结论通过砧镫关节脱位及砧骨及镫骨损伤的HRCT诊断与手术结果对照分析,找出漏诊原因,有助于提高砧镫关节脱位的诊断准确率。Objective To analyze the HRCT features of traumatic dislocation of the incus and stapes joint.Methods In this wirk,we conducted a retrospective analysis of 14 patients with traumatic dislocation of the anvil and stapes joint confirmed by surgery,made the original CT image of the patients,performed routine axial,coronal,oblique and three-dimensional reconstruction,observed the dislocation of the incus and stapes joint and the injury of the incus and stapes,and compared with intra⁃operative diagnosis.Results Compared with the intraoperative diagnosis,7 cases were diagnosed with CT for the separation of the incus and stapes,9 cases were diagnosed intraoperatively,and the diagnostic accuracy rate was 77.78%.3 cases of complex dislocation of the anvil and stapes joint were diagnosed by CT,5 cases were found by operation,and the diagnostic accuracy rate was 60%.4 cases of dislocation of incus were diagnosed by CT,and 7 cases were found by operation.The diagnostic accuracy rate was 57.14%.None of stape dislocation was diagnosed by CT and 1 case was found by operation.The diagnostic accuracy rate was 0;CT diagnosis 2 cases of incus and stapes fractures were diagnosed by CT,and 4 cases were found by operation.The diag⁃nostic accuracy rate was 50%.Conclusion Through the comparison and analysis of HRCT diagnosis and surgical results of os⁃sicular injury and dislocation of the incus and stapes,the cause of missed diagnosis can be found out,which is helpful to improve the diagnostic accuracy of dislocation of the incus and stapes.

关 键 词：外伤 砧镫关节 体层摄影术 X线计算机 

分 类 号：R764.9[医药卫生—耳鼻咽喉科] R814.42[医药卫生—临床医学]