多层螺旋CT与核磁共振成像在膝关节隐匿性骨折中的诊断价值

Diagnostic Value of Multi-slice Spiral CT and Magnetic Resonance Imaging in Occult Fracture of Knee Joint

目的探讨多层螺旋CT与核磁共振成像在膝关节隐匿性骨折中的诊断价值。方法回顾性分析2015年1月—2017年12月于该院就诊的70例疑似膝关节隐匿性骨折患者,经复查以及部分手术,40例确诊为膝关节隐匿性骨折,另30例无膝关节隐匿性骨折。所有患者均分别行多层螺旋CT及核磁共振成像检查,所呈图像由2名或以上专业影像学医生进行双盲诊断,若最终诊断结果不统一,则全科会诊。对比两种检查方法在膝关节隐匿性骨折诊断中灵敏度、特异度及准确度。结果在70例疑似膝关节隐匿性骨折患者中,多层螺旋CT检出阳性41例,阴性29例,真阳性31例,真阴性20例,诊断灵敏度为77.50%,特异度为66.67%,准确性为72.85%,核磁共振成像检出阳性42例,阴性28例,真阳性39例,真阴性27例,诊断灵敏度为97.50%,特异度为90.00%,准确性为94.29%,核磁共振成像在膝关节隐匿性骨折临床诊断中的灵敏度、特异度及准确度均高于多层螺旋CT,差异有统计学意义(χ~2=7.314、4.812、11.706,P=0.007、0.028、0.001)。结论核磁共振成像在膝关节隐匿性骨折中的诊断价值高于多层螺旋CT,灵敏度、特异度及准确度更高。

Objective To investigate the diagnostic value of multi-slice spiral CT and magnetic resonance imaging in occult fractures of the knee. Methods A retrospective analysis of 70 patients with suspected occult fractures of the knee from January 2015 to December 2017 was performed. In the review and partial surgery, 40 patients were diagnosed as occult knee fractures and 30 patients had no knee joints occult fracture. All patients underwent multi-slice spiral CT and MRI. The images were double-blindly diagnosed by two or more professional imaging doctors. If the final diagnosis was not uniform, the general consultation would be conducted. Compare the sensitivity, specificity and accuracy of the two methods in the diagnosis of occult fractures of the knee. Results Among the 70 patients with suspected occult fractures of the knee, 41 cases were positive by multi-slice spiral CT, 29 cases were negative, 31 cases were true positive, 20 cases were true negative, the diagnostic sensitivity was 77.50%, and the specificity was 66.67%. The sex was 72.85%, 42 cases were positive by MRI, 28 cases were negative, 39 cases were true positive, 27 cases were true negative, the diagnostic sensitivity was 97.50%, the specificity was 90.00%, the accuracy was 94.29%, and MRI was in sensitivity, specificity and accuracy of the clinical diagnosis of occult fractures of the knee were higher than those of multi-slice spiral CT, and the difference was statistically significant （χ2=7.314, 4.812, 11.706, P=0.007, 0.028, 0.001）. Conclusion The diagnostic value of magnetic resonance imaging in occult fractures of the knee is higher than that of multi-slice spiral CT, and the sensitivity, specificity and accuracy are higher.