MSCT与X射线数字成像对胫骨平台隐匿性骨折诊断的价值分析

Analysis on the Value of MSCT and X-ray Digital Imaging in the Diagnosis of Latent Fracture of Tibial Plateau

目的:分析多层螺旋CT(MSCT)与X射线数字成像(DR)对胫骨平台隐匿性骨折(TPOF)的诊断价值。方法:选择临床高度怀疑为TPOF的患者89例,均予以DR诊断检查,对于仍不能明确诊断者行MSCT检查。结果:27例经DR明确诊断,诊断率为30.3%;余62例DR检查阴性,MSCT检查56例确诊TPOF,另6例仍未能明确诊断,TPOF诊断率为90.3%。与DR相比,CT对于骨折塌陷、错位及周围软性结构改变显示效果评分均明显较高(P<0.05)。62例同时接受DR、CT检查的患者中,CT检查对胫骨平台塌陷、胫骨平台水平错位诊断阳性率为51.6%、61.3%,均明显高于DR检查的12.9%、9.7%(P<0.05)。结论:MSCT对于临床可疑或DR阴性的TPOF具有更强的诊断能力,可为临床治疗及预后评估提供可靠依据。

Objective:To analyze the diagnostic value of multi-slice spiral CT(MSCT)and X-ray digital radiography(DR)for tibial plateau occult fracture(TPOF).Methods:A total of 89 patients with clinically highly suspected TPOF were selected and diagnosed by DR.MSCT examination was performed for those who were still unable to confirm the diagnosis.Results:Among them,27 cases were diagnosed by DR,and the diagnosis rate was 30.3%.The remaining 62 cases were negative for DR examination.There were 56 cases with TPOF diagnosed by MSCT,and the other 6 cases were still undiagnosed.The diagnosis rate of TPOF was 90.3%.Compared with DR,scores of CT in showing fracture collapse,dislocation and surrounding soft structural changes were significantly higher(P<0.05).Among the 62 patients who underwent DR and CT examinations,the positive rates of CT examination for tibial plateau collapse and tibial plateau dislocation(51.6%and 61.3%)were significantly higher than those of DR examination(12.9%and 9.7%)(P<0.05).Conclusion:The diagnostic ability of MSCT is relatively higher for clinically highly suspected or DR-negative TPOF,which provides reliable basis for clinical treatment and evaluation of prognosis.