X线平片和CT影像对脊柱爆裂型骨折的诊断价值对比分析

Contrast of Clinical Significance Between X ray and CT in Diagnosing Bursting Fracture of Vertebral Column

目的:探讨X线平片和CT影像在临床上诊断脊柱爆裂型骨折的应用,并对比分析两者影像学诊断上的特点。材料与方法:选取83例我院2011年10月-2014年10月确诊的脊柱爆裂型骨折的病人,对其CT平扫(加三维重建)和X线平片进行资料和相关影像学的回顾性分析,对比其诊断正确率的差别和其他诊断内容的差异。结果本研究共收集确诊的脊柱爆裂型骨折病人83例,其中单纯依赖CT诊断出79例,单纯依赖X线诊断出65例,两者对比X2=10.270,P=0.00135,差异有统计学意义。在横突或棘突骨折、小关节脱位、椎体直径宽、椎管狭窄、椎弓间距加宽等方面对CT和X线影像学资料进行分析,进行t检验,t=-2.421 P=0.042,差异有统计学意义。结论在临床上诊断脊柱爆裂型骨折CT整体优于X线,尤其在横突或棘突骨折、小关节脱位、椎体直径宽、椎管狭窄、椎弓间距加宽等方面优于X线。但X线方便、快速、经济,且对脊柱爆裂型骨折有一定的诊断价值,因此临床上应首选X线,对X线诊断不清的病例应常规行CT平扫,综合X线和CT诊断将明显提高确诊率。

Purpose： This study aims to compare the significance of CT and X ray in diagnosing bursting fracture of Vertebral column, meanwhile, to discuss the characteristics of the image of CT and X ray. Materials and Methods： We collect the clinical data. X ray and CT image of 83 patients which was diagnosed definitely as bursting fracture of vertebral col- umn during october. 2013-October. 2014 in our hospital. Then we compared the diagnostic accuracy of CT and X ray, and discuss other diagnostic contents of CT and X ray. Results： 79 patients with bursting fracture of vertebral column was suc- cessfully detected by CT, while 65 by X ray（X 2 = 10. 270, P = 0. 00135 ）. From the some other aspect of bursting fracture （ the stenosis of spinalis canalis, the width of centrum and so on）, there are significant differences between CT and X ray in diagnosing this disease（ t = - 2. 421 P = 0. 042）. Conclusion： CT has more advantage than X ray in diagnosing the bursting fracture, but X ray has its unique features, so in diagnosing this fracture, we had better detect bursting fracture of Vertebral column with X ray and CT together.