螺旋CT三维重建指导股骨转子间骨折分型及稳定性评估  

Effect of Spiral CT Three-Dimensional Reconstruction in Guiding Classification and Stability Evaluation of Intertrochanteric Femoral Fracture

作　　者：冯吉庆 祁学强 曹华佗 贺世集 谢斌[1] FENG Ji-qing;QI Xue-qiang;CAO Hua-tuo;HE Shi-ji;XIE Bin(Orthopedic Third Ward,Yan'an People's Hospital,Yan'an,Shaanxi,716000,China;Orthopedic First Ward,Yan'an People's Hospital,Yan'an,Shaanxi,716000,China)

机构地区：[1]延安市人民医院骨科三病区,陕西延安716000 [2]延安市人民医院骨科一病区,陕西延安716000

出　　处：《现代生物医学进展》2024年第20期3996-4000,共5页Progress in Modern Biomedicine

基　　金：延安市科技计划项目(2021YF-18)。

摘　　要：目的:探究螺旋CT三维重建指导股骨转子间骨折(IFF)分型及稳定性评估的应用价值。方法:选取2022年1月-2023年11月于本院接受手术治疗的102例IFF患者为对象,所有患者均于术前接受X线、螺旋CT扫描,分析患者CT三维重建成像典型影像表现;以术中诊断的Evans-Jensen分型为"金标准",评估CT三维重建对IFF分型、稳定性诊断的准确性。结果:102例IFF患者中,Evans-Jensen分型为Ⅰ型17例、Ⅱ型48例、Ⅲ型27例、Ⅳ型6例、Ⅴ型4例。术前CT三维重建诊断IFF分型的准确率为94.12%(Kappa值=0.864),明显高于术前X线片诊断IFF分型的准确率(84.31%、Kappa值=0.725),差异比较有统计学意义(P<0.05)。术前CT三维重建对冠状位骨折、外侧壁不完整及骨折端不稳定的检出率均高于X线片(P<0.05)。结论:螺旋CT三维重建对Evans-Jensen分型的诊断准确率较高,与术中诊断结果一致性较好,同时可准确呈现IFF骨折的详细解剖学变化。Objective:To explore the application value of spiral CT three-dimensional reconstruction in guiding classification and stability evaluation of intertrochanteric femoral fracture(IFF).Methods:A total of 102 patients with IFF who underwent surgical treatment in the hospital from January 2022 to November 2023 were selected as the subjects.All patients underwent X-ray and spiral CT scanning before surgery.The typical imaging manifestations of CT three-dimensional reconstruction were analyzed.With Evans-Jensen classification of intraoperative diagnosis as the gold standard,the accuracy of CT three-dimensional reconstruction in diagnosing the type and stability of IFF was evaluated.Results:In this study,Evans-Jensen classification results showed 17 cases of type I,48 cases of type II,27 cases of type III,6 cases of type IV,and 4 cases of type V.The accuracy of preoperative CT three-dimensional reconstruction for diagnosing the type of IFF was 94.12%(Kappa value=0.864),which was significantly higher than that of preoperative X-ray(84.31%,Kappa value=0.725)(P<0.05).The detection rates of preoperative CT three-dimensional reconstruction for coronary fractures,incomplete lateral wall,and unstable fracture ends were higher than those of X-ray(P<0.05).Conclusion:Spiral CT three-dimensional reconstruction is accurate for diagnosing Evans-Jensen type of IFF,and is consistent with intraoperative diagnostic results.At the same time,it can accurately present detailed anatomical changes of IFF.

关 键 词：股骨转子间骨折 X线 螺旋CT三维重建 Evans-Jensen分型 稳定性 

分 类 号：R604[医药卫生—外科学]