多层螺旋CT三维重建技术在踝关节骨折诊断和术后评估中的应用价值

3D dimensional reconstruction of multislice spiral CT value in the diagnosis of ankle fractures and postoperative evaluation

目的探讨多层螺旋CT三维重建技术在踝关节骨折诊断和术后评估中的应用价值。方法分别采用X线DR和多层螺旋CT三维重建技术对踝关节骨折患者进行术前检查并分型,术后进行复查观察复位质量和内固定置入质量。结果术前DR分型与术中所见结果比较,PAB、PER、SAB SER型Kappa值分别为0.76、0.80、0.77、0.75,一致性较好。术前CT三维重建与术中所见结果比较,PAB、PER、SAB SER型Kappa值分别为1、0.92、0.90、0.90,一致性优秀,CT三维重建分型与术中所见结果的一致性,灵敏度、特异度远优于DR。术后DR与CT三位重建对PAB、PER、SER型复位质量比较均有显著性差异(P<0.05),CT三维重建PER、SER型内固定置入质量比较均有显著性差异(P<0.05)。结论多层螺旋CT三维重建对踝关节骨折术前分型及术后复位治疗、内固定置入质量更准确、可靠,应用价值较高。

Objective To investigate the 3D reconstruction of multislice spiral CT technology applications in the diagnosis and postoperative ankle fracture assessment. Methods DR using X-ray and 3D reconstruction of multislice spiral CT technique in patients with ankle fractures preoperative examination and classification, for review after observing the quality of reduction and fixation into quality. Results Preoperative DR typing results compare with intraoperative findings, PAB, PER, SAB SER type Kappa values were 0.76, 0.80, 0.77, 0.75, had a good consistency. Preoperative CT reconstruction with intraoperative findings result of the comparison, PAB, PER, SAB SER type Kappa values were1, 0.92, 0.90, 0.90, excellent consistency, CT reconstruction typing and intraoperative findings consistent results. The sensitivity and specificity were far superior to DR. DR and CT reconstruction after treatment in PAB, PER, SER type reset mass were significantly different（P〈0.05）, CT three reconstruction PER, fixed into the SER type mass was significantly different（P〈0.05）. Conclusion Spiral CT reconstruction of ankle fracture before surgery and postoperative reduction treatment, quality assessment and internal fixation into a higher accuracy than the X-ray examination, and more reliable.