62排螺旋CT及其后处理技术对胫骨平台骨折及其分型的诊断价值  

Diagnostic value of 62-slice spiral CT and its post-processing techniques for tibial plateau fracture and its classification

作　　者：刘秀 贾霜 周志娇 杨阳 罗伟 唐鸿杰 LIU Xiu;JIA Shuang;ZHOU Zhi-jiao;YANG Yang;LUO Wei;TANG Hong-jie(Department of Radiology and Imaging,Nanchong Hospital of Traditional Chinese Medicine,Nanchong Sichuan 637000,China)

机构地区：[1]南充市中医医院放射影像科,四川南充637000

出　　处：《局解手术学杂志》2024年第11期995-998,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：南充市科技计划项目(21YFZJ0071)。

摘　　要：目的探究62排螺旋CT及其后处理技术对胫骨平台骨折(TPF)的诊断价值以及对治疗方案选择的影响。方法纳入2021年1月至2022年12月在我院进行诊治的173例TPF患者,以手术病理诊断为金标准,比较X射线及CT扫描检查的诊断准确率、分型诊断准确率及骨折端塌陷程度准确率。结果CT及其后处理技术较X射线能够更清晰地显示骨折线的走向、骨折碎片的移位方向及关节面的塌陷程度,171例患者术中所见骨折形态均与CT及其后处理图像一致。X射线对TPF诊断准确率为93.64%,低于CT及其后处理技术对TPF诊断准确率(98.84%),差异有统计学意义(χ^(2)=6.474,P=0.011)。X射线对骨折端塌陷程度评估总准确率显著低于CT三维重建(65.32%vs.90.75%;χ^(2)=32.644,P<0.001)。CT及其后处理技术对TPF Schatzker分型总准确率为97.69%,高于X射线对TPF Schatzker分型总准确率(88.44%),差异有统计学意义(χ^(2)=11.462,P=0.001)。CT不同重建模式对TPF Schatzker分型诊断总准确率差异有统计学意义(χ^(2)=40.647,P<0.001),其中容积再现诊断准确率最高(96.53%)。结论应用CT检查及其后处理技术可有效评估TPF、关节面塌陷、骨折分型,并为临床决策提供影像学参考。Objective To investigate the diagnostic value of 62-slice spiral CT and its post-processing techniques for tibial plateau fracture(TPF)and its influence on treatment regimens selection.Methods A total of 173 TPF patients diagnosed and treated in our hospital from January 2021 to December 2022 were included,and the diagnostic accuracy,classification diagostic accuracy and fracture collapse degree accuracy of X-ray and CT scans were compared,with surgical and pathological diagnosis as the gold standard.Results CT and its post-processing technique can more clearly show the direction of fracture line,the displacement direction of fracture fragments and the collapse degree of articular surface than X-ray.The fracture morphology of 171 patients seen during the operation was consistent with CT and its post-processing images.The diagnostic accuracy of X-ray for TPF was 93.64%,which was lower than that of CT and its post-processing techniques(98.84%),and the difference was statistically significant(χ^(2)=6.474,P=0.011).The overall accuracy of X-ray in evaluating the degree of fracture collapse was significantly lower than that of CT 3D reconstruction(65.32%vs.90.75%;χ^(2)=32.644,P<0.001).The total accuracy of CT and its post-processing techniques for TPF Schatzker classification(97.69%)was higher than that of X-ray(88.44%),and the difference was statistically significant(χ^(2)=11.462,P=0.001).Different CT reconstruction models had statistically significant difference on the total accuracy of TPF Schatzker classification diagnosis(χ^(2)=40.647,P<0.001),and the diagnosis accuracy of volume reconstruction was the highest(96.53%).Conclusion The application of CT and its post-processing techniques can effectively evaluate TPF,articular surface collapse and fracture classification,and provide imaging reference for clinical decision-making.

关 键 词：胫骨平台骨折 SCHATZKER分型 X射线 62排螺旋CT检查 诊断 

分 类 号：R445[医药卫生—影像医学与核医学]