膝关节隐匿性骨折诊断中MSCT与MRI的应用价值

Application Value of MSCT and MRI in Diagnosis of Occult Fracture of Knee Joint

目的:探讨膝关节隐匿性骨折诊断中多层螺旋CT(MSCT)与磁共振(MRI)的应用价值.方法:回顾性分析近3年笔者所在医院112例疑似膝关节隐匿性骨折患者的临床资料.均分别行MSCT、MRI检查.以关节镜或手术病理结果为标准,判断MSCT、MRI诊断效能.结果:本组112例患者中,经关节镜或手术病理结果证实膝关节隐匿性骨折92例,其中25例股骨外侧踝骨折,18例股骨内侧踝骨折,37例胫骨近端骨折,12例同侧股骨及胫骨关节面邻端骨折;MSCT诊断敏感度、特异度、准确度分别为89.13%、70.00%、85.71%,低于MRI的97.83%、100%、98.21%,差异有统计学意义(P<0.05).结论:MRI诊断膝关节隐匿性骨折价值较MSCT更高,可提升诊断敏感度、特异度、准确度,值得临床推广.

Objective:To investigate the value of multi-slice spiral CT(MSCT)and magnetic resonance imaging(MRI)in the diagnosis of occult fracture of knee joint.Method:The clinical data of 112 patients with suspected occult fracture of knee joint in our hospital in recent three years were retrospectively analyzed.MSCT and MRI were performed respectively.The diagnostic efficacy of MSCT and MRI was judged according to the results of arthroscopy or operation and pathology.Result:Among 112 patients,92 cases of occult fracture of knee joint were confirmed by arthroscopy or surgical pathology,including 25 cases of lateral femoral ankle fracture,18 cases of medial femoral ankle fracture,37 cases of proximal tibial fracture,12 cases of ipsilateral femoral and adjacent tibial articular surface fracture.MSCT diagnostic sensitivity,specificity and accuracy were 89.13%,70.00%,85.71%,lower than 97.83%,100%and 98.21%of the MRI,the differences were statistically significant(P<0.05).Conclusion:The value of MRI in the diagnosis of occult fracture of knee joint is higher than that of MSCT,which can improve the sensitivity,specificity and accuracy of diagnosis,and is worthy of clinical promotion.