CR与CT对MasonⅠ型桡骨小头骨折的诊断价值

Diagnostic value of CR and CT in the mason Ⅰ Radius capitulum france

目的评价CR与CT对桡骨小头Mason Ⅰ型骨折的诊断价值,为临床医师选择合适的检查提出建设性意见。方法回顾性分析56例经临床确诊为桡骨小头Mason Ⅰ型骨折患者的CR、CT及临床资料,对桡骨小头是否存在骨折、骨折部位、骨折线数量、有无累及关节面、关节面是否塌陷进行重点观察并作简要统计学分析。结果 56例患者外伤8h内均行CR及CT检查,CR诊断桡骨小头骨折38例,怀疑10例,阴性8例,诊断准确率67.86%,阳性率85.71%,漏诊率14.29%;单纯CT轴位明确诊断47例,诊断准确率83.93%,漏诊或不确定骨折9例,漏诊率16.07%;CT薄层重建结合后处理技术诊断53例,怀疑3例,无漏诊病例,诊断准确率94.64%,阳性率为100%。结论 CR对桡骨小头Mason Ⅰ型骨折有较高的检出率,仍可作为首选的检查方式,但伴有肘部脂肪垫翘起及临床有明显的疼痛症状而CR检查阴性或怀疑时,应选择CT检查,薄层重建和CT后处理技术的综合运用是避免漏诊的关键。

Objective To evaluate the values of CR and CT in the diagnosis of Mason I Radius capitulum France, thereby providing reference frame for doctors to select the appropriate check inspects in the diagnosis of this kind of dis- ease. Methods According to comparing the clinical indices （whether the presence of fractures, position, quantity of frac- ture line, whether implicate articular surface and whether exist serious subsidence） of 56 samples with Mason I Radius capitulum France after CR and CT tests, we observed and analyzed the statistical data briefly. Results Both 56 samples had been accepted CR and CT examination within 8 hours after injury, in which 38 samples had been determined with this disease, 10 of them could not been determined and the rest 8 of them with negative results. The diagnostic accuracy, de- tection rate and misdiagnosis rate were 67.86%, 85.71% and 14.29% respectively. However, the diagnostic accuracy, detection rate and misdiagnosis rate were 83.93% （47） and 16.07% respectively, in which 9 samples could not been deter- mined by Axial CT. 53 cases had been confirmed with fracture through the thin slice CT reconstruction combined with post-processing techniques, 3 cases could not heed determined there were no missed cases. The diagnostic accuracy and de- tection rate were 94.64% and 100% respectively. Conclusion CR can be used as the preferred method in the diagnosis of Mason I Radius capitulum France due to its higher detection rate, however, when some cases assume negative or nonde- terminacy in CR test, such as patient with elbow fat pad tilt and clinically significant pain symptoms, CT would be a better choice than CR. Therefore integrated use of thin slice reconstruction and processing technology in CT examination are the key of avoiding missed diagnosis.