CT三维重建与X线在髋臼骨折术前及术后评价中的价值对比

Comparison of Values of Three-Dimensional CT Reconstruction and X-ray in the Preoperative and Postoperative Evaluation of Acetabular Fractures

目的对比分析CT三维重建与X线在髋臼骨折术前及术后评价中的应用价值。方法回顾性分析2016年9月至2019年9月永城市人民医院收治的45例外伤性髋臼骨折患者的术前、术后X线片及CT三维重建影像,对比术前髋臼骨折检出率、骨折分型正确率、骨折移位判断正确率以及术后骨折复位质量与内固定物置入效果。结果术前,X线片的骨折检出率为60.00%、骨折分型正确率为48.89%、骨折移位判断正确率为53.33%,明显低于CT三维重建影像的骨折检出率100%、骨折分型正确率100%、骨折移位判断正确率100%(χ~2=22.500、33.978、27.391,P均=0.000)。术后,X线检查骨折复位质量良好率为77.78%,内固定物置入满意率为91.11%;CT三维重建检查骨折复位质量良好率为75.56%,内固定物置入满意率为86.67%,两组骨折复位质量对比,Z=-2.751,P=0.006,P <0.05,差异具有统计学意义;内固定物置入效果对比,Z=-1.556,P=0.120,P>0.05,差异无统计学意义。结论与X线相比,CT三维重建技术在髋臼骨折术前诊断及术后评价中的应用价值更大,不仅诊断准确率高,而且还能精确评估手术质量,对髋关节的功能恢复具有重要指导意义。

Objective To compare and analyze the application value of three-dimensional CT reconstruction and X-ray in the preoperative and postoperative evaluation of acetabular fractures.Methods Retrospective analysis of preoperative and postoperative X-ray films and three-dimensional CT reconstruction images of 45 patients with traumatic acetabular fractures,admitted to The People’s Hospital of Yongcheng from September 2016 to September 2019,was performed and fracture detection rate,accuracy of fracture classification,accuracy of displacement judgment before surgery,and quality of fracture reduction and internal fixation effect after surgery were compared.Results Before surgery,the fracture detection rate,the accuracy of fracture classifcation and accuracy of fracture displacement judgment detected with X-ray films were60.00%,48.89% and 53.33% respectively,which were significantly lower than those detected with three-dimensional CT reconstruction-100%(χ~2=22.500,33.978,27.391,all P=0.000).After surgery,the rate of good fracture reduction and the satisfaction rate of internal fixation detected with X-ray were 77.78% and 91.11% respectively and these indicators detected with three-dimensional CT reconstruction were 75.56% and 86.67% respectively.The comparison of fracture reduction quality between the two groups(Z=-2.151,P=0.006,P <0.05) showed statistically significant difference;the comparison of internal fixation effect between the two groups(Z=-1.556,P=0.120,P> 0.05) showed no statistically significant difference.Conclusion Compared with X-ray film detection,three-dimensional CT reconstruction has a higher application value in the preoperative diagnosis and postoperative evaluation of acetabular fractures.It features high diagnostic accuracy and can accurately evaluate the quality of surgery,which is of great significance for the functional recovery of hip joint.