CT三维重建在股骨转子间骨折AO分型中的价值

The value of CT 3D reconstruction in intertrochanteric fracture AO classification

目的探讨CT三维重建在股骨转子间骨折AO分型准确性、一致性以及稳定性评估中的优越性。方法由3名医生阅读术前X线片,并按AO分型方法进行骨折分型、稳定性评估并讨论获得一致结论;同样方法阅读术前CT三维重建图像,获得分型、稳定性评估及一致结论。对两者结论不同的病例由3名医生共同阅读X线片及CT三维重建图像,经讨论得出一致分型及稳定性评估结论,加上基于X线片和CT三维重建相同的结论作为金标准。结果 3名医生基于CT三维重建AO分型的一致性、分型准确性均高于X线片。3名医生稳定性评估准确率:基于X线片不稳定性骨折比例均明显低于金标准,差异均有统计学意义(P <0. 01);基于CT三维重建比例与金标准比较差异均无统计学意义(P> 0. 05)。结论采用CT三维重建在股骨转子间骨折分型准确性、一致性以及稳定性评估明显优于X线片。

ObjectiveTo investigate the superiority of CT 3D reconstruction in the intertrochanteric fracture AO classification with consistency,accuracy and stability evaluation.MethodsThree doctors read preoperative X-ray films and performed fracture classification by AO classification method,fracture stability evaluation and reached consistent agreement.Similarly,three doctors read preoperative CT 3D reconstruction films and performed classification,fracture stability evaluation and reached consistent agreement.For cases with different conclusions,these three doctors jointly read all X-ray and CT 3D reconstruction images and obtained consistent classification and stability evaluation conclusion,and the same conclusions based on X-ray films and CT 3D reconstruction were considered as the golden standard.ResultsThe data of consistency and classification accuracy based on CT 3D reconstruction were higher than the one based on X-ray films.Stability evaluation accuracy:the instability rate based on X-ray films was much lower than that of the golden standard,showing statistically significant differences(P<0.01).There were no statistically significant differences between the instability rate based on CT 3D reconstruction and the golden standard(P>0.05).ConclusionsCT 3D reconstruction is much better than X-ray films in terms of consistency,classification accuracy and stability evaluation of intertrochanteric fracture.