多层螺旋CT三维重建技术在胫骨平台骨折诊断和分型中的应用

Application of multi-slice spiral CT three-dimensional reconstruction in the diagnosis and classification of tibial plateau fractures

目的:探讨多层螺旋CT三维重建技术(MU)在胫骨平台骨折诊断和分型中的作用。方法:选择2018年1月—2019年4月检查并进行治疗的胫骨平台骨折患者60例,平均分为X线组(X组)和多层螺旋CT三维重建组(MU组)。X组用X线方法检测胫骨平台骨折患者;MU组用多层螺旋CT三维重建技术方法检测胫骨平台骨折患者。分析X组与MU组患者分型情况、合并髁间隆突骨折及合并腓骨小头骨折的检查情况及诊断价值的差异性。结果:按照Schatzker分型标准,X组X线诊断Ⅰ~Ⅴ型分别为7例、10例、8例、3例、2例,手术结果为5例、7例、10例、5例、3例,X组诊断结果与手术结果比较差异较大。MU组MU诊断Ⅰ~Ⅴ型分别为8例、10例、6例、4例、2例,手术结果为8例、10例、7例、3例、2例,MU组诊断结果与手术结果比较,差异较小,更准确。X组诊断出合并髁间隆突骨折5例,合并腓骨小头骨折4例;MU诊断分别为13例和12例,两组比较,X组检出率明显低于MU组(P<0.05)。MU组检测诊断的特异性、准确率均高于X组,差异有统计学意义(P<0.05)。两组诊断胫骨平台骨折的灵敏度比较,差异无统计学意义(P>0.05)。结论:对于胫骨平台骨折的诊断和分型,多层螺旋CT三维重建技术比X线更为准确。

Objective:To explore the role of multi-slice spiral CT three-dimensional reconstruction in the diagnosis and classification of tibial plateau fractures.Methods:Patients with tibial plateau fractures who were examined and treated in our hospital from January 20 to April 2019 were enrolled in this study.The selected patients were equally divided into two groups,the first group,X-ray group(X group):X-ray method was used to detect the tibial plateau fracture patients;the second group,multi-slice spiral CT three-dimensional reconstruction group(MU group):Multi-slice spiral CT three-dimensional reconstruction technique was used to detect this group of patients with tibial plateau fractures.30 cases in each group.To investigate the diagnosis and classification of tibial plateau fractures by multi-slice spiral CT three-dimensional reconstruction technique by analyzing the classification of patients in group X and MU,the examination of intercondylar carinal fractures and the diagnosis of humeral head fractures,and the difference in diagnostic value.Results:According to the table,theⅠ-V type of patients in group X were 7 cases,10 cases,8 cases,3 cases and 2 cases.The operation results were 5 cases,7 cases,10 cases,5 cases and 3 cases.The results were relatively different,but not statistically significant.The typeⅠ-Ⅴpatients in the MU group were 8 cases,10 cases,6 cases,4 cases and 2 cases,respectively.The surgical results were 8 cases,10 cases,7 cases,3 cases and 2 cases.Compared with the operation results,the difference between the MU group and the MU group was smaller and more accurate.Five patients in the X group were diagnosed with intercondylar fractures and 4 with fibula head fractures.The MU group was diagnosed with 13 and 12 patients.Compared with the MU group,the detection rate in the X group was significantly lower In the MU group(P<0.05).The specificity and accuracy of detection and diagnosis in the MU group were higher than those in the X group(P<0.05).Compared with the X group,the sensitivity of the MU group in the diagnosis of tibial plateau fractures was not significantly different(P>0.05).Conclusion:The multi-slice spiral CT three-dimensional reconstruction technique is more accurate than the X-ray diagnosis of the tibial plateau fracture.