三维CT重建及MRI在复杂性胫骨平台骨折中的临床应用价值

The Clinical Application Value of Three-Dimensional CT Reconstruction and MRI in Complex Tibial Plateau Fractures

目的:探讨临床在诊断复杂性胫骨平台骨折患者时,予以三维CT重建及MRI检查的应用价值。方法:研究以2018年6月~2020年6月来本院接受诊治的48例复杂性胫骨平台骨折患者进行研究,均予以三维CT重建及MRI检查,对比两种诊断方法的符合率。结果:2种检查方法诊断符合率与骨折分型准确率对比,无显著性差异(P>0.05);三维CT重建检查骨折粉碎程度、骨折缺损情况的显像质量显著优于MRI检查,MRI检查周围损伤显像质量评分显著高于三维CT重建检查(P<0.05);患者经不同手术方式治疗后,平均随访(29.8±3.2)个月,手术时间平均为(1.9±0.5)h,术中失血量平均(434.2±85.9)mL。大部分患者骨折愈合情况良好。结论:临床在诊断复杂性胫骨平台骨折患者时,以三维CT重建及MRI检查诊断,均具有较高诊断率,必要时可联合2种方法实施诊断,进而为临床制定手术方案提供可靠依据。

Objective:To explore the clinical application value of three-dimensional CT reconstruction and MRI in the diagnosis of patients with complex tibial plateau fractures.Methods:The subjects of the study were conducted on 48 patients with complex tibial plateau fractures who came to our hospital for diagnosis and treatment from June 2018 to June 2020.All of them underwent three-dimensional CT reconstruction and MRI examination,and the coincidence rates of the two diagnostic methods were compared.Results:There was no significant difference between the diagnostic coincidence rate of the two inspection methods and the fracture classification accuracy rate(P>0.05);The imaging quality of three-dimensional CT reconstruction for the degree of fracture comminution and fracture defect was significantly better than that of MRI.MRI Peripheral injury imaging quality score was significantly higher than that of three-dimensional CT reconstruction(P<0.05);After the patients were treated with different surgical methods,the average follow-up was(29.8±3.2)months,and the average operation time was(1.9±0.5)hours.The average blood loss was(434.2±85.9)mL.The fracture healing of most patients is good.Conclusion:In the clinical diagnosis of patients with complex tibial plateau fractures,three-dimensional CT reconstruction and MRI diagnosis have a high diagnostic rate.If necessary,the two methods can be combined to perform the diagnosis,thereby providing a reliable basis for the clinical development of surgical plans.