CT联合MRI对膝关节隐匿性骨折的诊断价值研究

DIAGNOSTIC VALUE OF CT COMBINED WITH MRI IN OCCULT FRACTURE OF KNEE JOINT

目的 探究多层螺旋CT联合MRI对膝关节隐匿性骨折的诊断价值。方法 回顾性收集2021年6月—2022年6月130例疑似膝关节隐匿性骨折患者分别给予CT和MRI检查。以关节镜为金标准,比较CT、MRI和CT联合MRI的阳性检出率,通过构建ROC曲线来对比CT、MRI和CT联合MRI的诊断效能。结果 通过关节镜确诊121例隐匿性骨折。CT确诊86例隐匿性骨折,MRI确诊95例隐匿性骨折,CT联合MRI确诊118例隐匿性骨折。CT的AUC、灵敏度、特异度、阳性预测值和阴性预测值分别为0.736、69.4%、77.8%、69.4%、77.8%;MRI的AUC、灵敏度、特异度、阳性预测值和阴性预测值分别为0.833、77.7%、88.9%、77.7%、88.9%;CT联合MRI的AUC、灵敏度、特异度、阳性预测值和阴性预测值分别为0.988、97.5%、100%、97.5%、100%,P均<0.05。在膝关节不同部位隐匿性骨折的诊断准确度方面,与单独使用CT或MRI相比,CT联合MRI的诊断准确度较高,以上差异均有统计学意义(P<0.05)。结论 多层螺旋CT联合MRI可提高膝关节隐匿性骨折的诊断效能。

Objective To explore the diagnostic value of multi-slice spiral CT combined with MRI in occult fracture of knee joint.Methods From June 2021 to June 2022,one hundred and thirty patients with suspected occult fracture of knee joint were retrospectively collected and examined with CT and MRI respectively.Taking arthroscopy as the gold standard, the positive detection rates of CT,MRI and CT combined MRI were compared, and the diagnostic efficacy of CT,MRI and CT combined MRI was compared by constructing ROC curve.Results 121 cases of occult fractures were diagnosed by arthroscopy.86 cases of occult fractures were confirmed by CT,95 cases by MRI,and 118 cases by CT combined with MRI.The area under the curve(AUC),sensitivity, specificity, positive predictive value, and negative predictive value of CT were 0.736,69.4%,77.8%,69.4% and 77.8%,respectively.The AUC,sensitivity, specificity, positive predictive value, and negative predictive value of MRI were 0.833,77.7%,88.9%,77.7% and 88.9%,respectively.The AUC,sensitivity, specificity, positive predictive value, and negative predictive value of CT combined with MRI were 0.988,97.5%,100%,97.5% and 100%,respectively, P<0.05.In terms of diagnostic accuracy for occult fractures at different sites in the knee, the combination of CT and MRI was significantly more accurate than CT or MRI alone, P<0.05.Conclusion Multi slice spiral CT combined with MRI can improve the diagnostic efficiency of occult fracture of knee joint.