多排螺旋CT重建技术应用于踝关节骨折诊断的临床价值研究

Application of spiral CT tri-dimensional reestablishment in ankle joint fracture

目的探讨多排螺旋CT重建技术应用于踝关节骨折诊断的临床诊断价值。方法选择60例因踝部骨折来该院治疗的患者,根据Danis-Weber分型,其中WeberA型患者25例,WeberB型患者17例,We-berC1型患者13例,WeberC2型患者5例。对患者术前和术后均进行X线片与多排螺旋CT重建技术,并对其检查结果进行分析比较,并通过与影像学对踝关节术后主观功能和客观功能进行评分。结果患者术前行X线片检查漏诊11例,其中骨折为WeberA型者5例,骨折为WeberB型者3例,骨折为WeberC1型者2例,骨折为WeberC2型者为1例,后来踝关节骨折经多排螺旋CT重建技术纠正9例;术后随访时行X线片显示关节面未完全复位者3例,关节面完全复位者57例,而后经多排螺旋CT重建技术发现其中10例仍存在轻度关节面不平。结论多排螺旋CT重建技术能更全面、更准确地提供踝关节骨折的信息,有利于术前诊断、指导手术和疗效评估。

[ Objective ] To explore spiral CT tri-dimensional reestablishment in ankle joint fracture. [Methods] 60 cases were involved in treatment of ankle joint fracture in our hospital. According to Danis-Weber classification, 25 cases were WeberA, 17 cases were WeberB, 13 cases were WeberC1, 5 cases were WeberC2. Spiral CT tri-di- mensional reestablishment was performed before and after operation in all cases and their results was compared. The relationship of function assessment and the image evaluation were analyzed. [ Results ] 11 cases, of posterior malleo- lar fracture were not clear on plain radiography, 5 cases were WeberA, 3 cases were WeberB., 2 cases were We- berC1, 1 case was WeberC2. 9 cases were diagnosed preoperatively by spiral CT tri-dimensicnal reestablishment. One year after treatment, articular surface was incongruity in 3 cases by plain radiography, and it was congruity in 57 cases, of which 10 cases were found slight in congruity by spiral CT tri-dimensional reestablishment. [ Conclu- sions] Compared to plain radiography, spiral CT tri-dimensional reestablishment can provide more accurate and more comprehensive information for the cotton fracture, so as to facilitate diagnosis, operation and assessment of the outcomes in the treatment of cotton fractures.