64排螺旋CT多平面重建及容积再现技术在复杂胫骨平台骨折诊断中的应用

Application of 64-slice spiral CT multiplanar reconstruction and volume rendering technique in complex tibial plateau fractures

目的研究和探索64排螺旋CT多平面重建及容积再现技术在胫骨平台骨折诊断、分型以及制定方案时的价值和作用。方法对蚌埠市第三人民医院2020年6月—2021年12月收治的69例疑似胫骨平台骨折患者资料进行收集整理,通过CT扫描的方式获得胫骨骨折的相关数据信息,然后借助ADW4.4工作站对数据进行多平面重建和容积再现,以此来诊断患者的病情。相对于X线片,分析研究诊断符合率以及分型正确率情况。结果共计确诊胫骨平台骨折患者65例,其中男性35例,女性30例。平均年龄为(48.98±15.68)岁。本研究人群50~59岁年龄段患者所占比例最高(26.2%)。其次为40~49岁年龄段,占比为23.1%。Schatzker Ⅰ型胫骨平台骨折为高发类型,共19例,占骨折总数的29.2%,SchatzkerⅡ型次之,占比26.2%,其次为Schatzker Ⅲ型和Schatzker Ⅳ型,均占13.8%。不同性别Schatzker分型情况差异无统计学意义(P>0.05)。与手术分型标准相比,X线诊断结果的准确率为81.5%(53/65),CT MPR+VR诊断结果准确率为98.5%(64/65),差异有统计学意义(χ^(2)=10.342,P<0.01)。结论通过64排螺旋CT进行多平面重建和容积再现,能很好地识别和诊断出患者胫骨骨折的真实情况,还能深度发掘患者关节周隐匿性损害,为临床治疗提供有力的依据。

Objective To investigate the value of 64-slice spiral CT multiplanar reconstruction(MPR)and volume rendering(VR)technique in the diagnosis,classification and treatment plan of tibial plateau fractures.Methods The clinical data of 69 suspected patients with tibial plateau fracture in the Third people’s Hospital of Bengbu from June 2020 to December 2021 were selected.The relevant data of tibial fracture were obtained by CT scanning,and the data were reconstructed and volume reconstructed by ADW4.4 workstation to diagnose the patient’s condition.Compared with diagnostic of X-ray,the diagnostic coincidence rate and typing accuracy were analyzed and studied.Results A total of 65 patients with tibial plateau fractures were diagnosed,including 35 males and 30 females,the average age was(49.69±15.91)years.In this study,patients aged 50-59 years accounted for the highest proportion(26.2%),followed with patients aged 40-49 years(23.1%).Schatzker type Ⅰ tibial plateau fracture was the most common type,with 19 cases(29.2%),followed by Schatzker type Ⅱ(26.2%),Schatzker type Ⅲ(13.8%)and Schatzker type Ⅳ(13.8%).There was no significant difference in Schatzker classification between Sexes(P>0.05).Compared with the standard of surgical classification,the accuracy of X-ray diagnosis was 81.5%(53/65),and the accuracy of CT MPR+VR was 98.5%(64/65),with statistically significant difference(χ^(2)=10.342,P<0.01).Conclusion 64-slice spiral CT multiplanar reconstruction and volume reconstruction technology can well identify and diagnose the true situation of tibial fracture,and deeply explore the hidden damage around the joint,which can provide a powerful basis for clinical treatment.