多层螺旋CT对胫骨近端隐匿性骨折的诊断价值

Diagnostic value of multi-slice spiral CT in occult fractures of proximal tibia

目的探讨多层螺旋CT对胫骨近端隐匿性骨折的诊断价值。方法回顾性分析23例数字放射摄影诊断可疑胫骨近端骨折病例的16层螺旋CT的横轴位、多平面重建、容积再现、最大密度投影,观察多层螺旋CT对胫骨近端隐匿性骨折的诊断率。结果所选病例数字放射摄影均未显示明确骨折线,16层螺旋CT诊断胫骨近端骨折17例,其中胫骨平台骨折13例、胫骨髁间棘骨折4例;排除骨折6例,阳性率达73.9%。结论多层螺旋CT对临床怀疑胫骨近端骨折而数字放射摄影不能确诊为骨折的病例能准确地作出诊断,对治疗方案的选择及预后的估计有重要价值。

Objective To discuss the diagnostic value of multi-slice spiral CT for the occult fracture of proximal tibia.Methods 23 patients with suspected fracture of proximal tibia by digital radiography were studied,and their images of transverse,multiplanar reconstruction,and volume rendering and maximum intensity projection of 16-slice spiral CT were analyzed.The diagnostic rate for occult fracture of proximal tibia with multi-slice spiral CT was observed. Results Digital radiography showed no definite fracture signs in all patients.16-slice spiral CT showed fractures in 17 cases,including fractures of tibia plateau in 13 cases and tibia eminence in 4 cases.The other 6 patients showed negative on 16-slice spiral CT images.Conclusion Multi-slice spiral CT can be used to diagnose definitely occult fractures of proximal tibia and plays an important role in selecting therapy project and evaluating prognosis of occult fractures.