超声与X线在诊断儿童青枝骨折中的对比研究  

Application of Ultrasound in Children with Limb Long Bone Green Branch Fracture

作　　者：卓招兰 吴振斌 李炳钻 揭强 林文梅 林金泉 李拾林[4] Zhuo Zhaolan;Wu Zhenbin;Li Bingzuan;Jie Qiang;Lin Wenmei;Lin Jinquan;Li Shilin(Department of Ultrasound,Quanzhou Orthopedic-Traumatological Hospital of Fujian,Quanzhou,Fujian 362000,China;Department of Medical Imaging,Quanzhou Orthopedic-Traumatological Hospital of Fujian,Quanzhou,Fujian 362000,China;Department of Pediatric Orthopaedic,Quanzhou Orthopedic-Traumatological Hospital of Fujian,Quanzhou,Fujian 362000,China;Department of Ultrasound Medicine,The Second Affiliated Hospital of Fujian Medical University,Quanzhou,Fujian 362000,China)

机构地区：[1]福建省泉州市正骨医院超声科,福建省泉州市362000 [2]福建省泉州市正骨医院医学影像科,福建省泉州市362000 [3]福建省泉州市正骨医院小儿骨科,福建省泉州市362000 [4]福建医科大学附属第二医院超声医学科,福建省泉州市362000

出　　处：《中国超声医学杂志》2024年第7期813-816,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 比较超声与X线检查在诊断儿童四肢长骨青枝骨折中的应用价值。方法 收集临床高度怀疑四肢长骨青枝骨折,初诊均行超声和X线检查的患儿60例(70处)。并于2周后复查X线,失访9例(10处),资料完整51例(60处)。其中男35例(42处)、女16例(18处),平均年龄6岁,发生部位桡骨25处、肱骨14处、尺骨12处、胫骨4处、腓骨3处、指骨1处、趾骨1处。比较初次超声与X线的检出率。结果 超声诊断的准确度高于X线[95.0%(57/60)vs.75.0%(45/60),P<0.05]。超声灵敏度为97.7%,特异度为87.5%,受试者工作特征(ROC)曲线下面积为0.926,P<0.001;X线灵敏度为68.2%,特异度为93.7%,ROC曲线下面积为0.810,P<0.001。结论 超声可作为X线未检出的儿童四肢长骨青枝骨折的补充性检查手段,能进一步提高诊断率,减少漏诊误诊。Objective To compare the application value of ultrasound and X-ray in the diagnosis of long bone green branch fracture in children.Methods A total of 60(70 bones)cases of children with high clinical suspicion of limbs long bone green branch fracture were collected.Ultrasound and X-ray examinations were performed for the first time,and X-ray examinations were performed 2 weeks later,with complete data in 60 cases,lost follow-up in 9(10 bones) cases.Among them,35(42 bones) were males and 16(18 bones) were females,with an average age of 6 years.The fractures occurred in 25 radials,14 humerus,12 ulnas,4 tibias,3 fibulas,1 phalanges of hands and 1 phalanges of foot.The detection rate of initial ultrasound and X-ray was compared.Results The diagnosis accuracy of ultrasound and X-ray were 95.0%(57/60) and 75.0%(45/60) respectively(P<0.05).The sensitivity and specificity of ultrasound were 97.7%,and 87.5%.The area under the receiver operating characteristic(ROC) curve was 0.926(P<0.001);The sensitivity and specificity of X-ray were 68.2% and 93.7%.The area under the ROC curve was 0.810(P<0.001).Conclusions Ultrasound is a reliable method to diagnose green branch fractures of limbs in children.When X-ray is negative but the green branch fractures are highly suspected,ultrasound can improve the diagnosis rate and reduce missed diagnosis and misdiagnosis.

关 键 词：儿童 青枝骨折 超声 四肢长骨 

分 类 号：R445.1[医药卫生—影像医学与核医学] R726.8[医药卫生—诊断学] R816.92[医药卫生—临床医学]