多层螺旋CT平扫及三维重建对桡骨骨折的术前评估及临床治疗应用价值探讨

Application Value of Multi-slice Spiral CT Plain and Three-dimensional Reconstruction in the Preoperative Evaluation and Clinical Treatment of Radius Fractures

目的旨在探讨多层螺旋CT平扫及三维重建对桡骨骨折的术前评估及临床治疗应用价值。方法回顾性分析2016年8月到2018年6月于我院就诊治疗的76例桡骨骨折患者的病例资料,分析不同检查方法对桡骨骨折的诊断符合率,并总结桡骨骨折的影像学特征表现。结果多层螺旋CT平扫及三维重建检查对桡骨远端骨折块数检出显著多于X线,矢状面骨折位移距离和冠状面积腕关节面塌陷度也显著大于X线,且对桡骨骨折分型诊断符合率(97.37%)显著高于X线检查(65.79%)(P<00.05);CT平扫可示骨折关节面出现压缩性塌陷,矢状面可见骨折处骨皮质不连续且出现游离骨块影,三维重建检查在矢状面可显示远端关节面可被累及,游离骨块影可被见;骨折断端出现成角变形,而腕关节间隙变窄,所有患者根据图像均行切开复位内固定治疗,术后复查X线检查显示断端对位对线良好。结论多层螺旋CT平扫及三维重建检查对桡骨骨折诊断符合率更高,且临床可根据图像资料制定相关手术方案,更有利患者恢复。

Objective To investigate the preoperative evaluation and clinical application value of multi-slice spiral CT plain scan and three-dimensional reconstruction for radial fractures. Methods Retrospective analysis was performed on the case data of 76 patients with radial fractures treated in our hospital from August 2016 to June 2018. The diagnostic coincidence rate of different examination methods for radial fractures was analyzed, and the imaging characteristics of radial fractures were summarized. Results MSCT and 3 d reconstruction examination revealed significantly more radial distal fracture masses than X-ray, sagittal fracture displacement distance and coronal area of wrist surface collapse were also significantly greater than X-ray, and the diagnostic coincidence rate of radial fracture classification was significantly higher(97.37%) than X-ray examination(65.79%)(P<00.05). CT plain scan can show compression collapse in the articular surface of fracture, discontinuous bone cortex and free bone shadow can be seen in the sagittal plane,3 d reconstruction examination can show involvement of the distal articular surface and free bone shadow can be seen in the sagittal plane. Angular deformity occurred at the broken end of the fracture, and the gap of the wrist joint was narrowed. All patients were treated with open reduction and internal fixation according to the images. Postoperative X-ray examination showed that the alignment of the broken end was good. Conclusion MSCT and 3 d reconstruction have higher diagnostic coincidence rate for radial fracture,and relevant surgical plans can be made according to clinical image data, which is more favorable for patients’ recovery.