多层螺旋CT与X射线摄影评估股骨粗隆骨骨折分型及应用价值分析

Analysis of MSCT and X-ray in assessing the classification of femoral trochanteric fracture and the application value of that

目的:探讨多层螺旋CT(MSCT)与X射线摄影在评估股骨粗隆骨骨折分型中的应用价值。方法:选取医院收治的80例股骨粗隆骨骨折患者,以手术解剖分型为“金标准”,对比X射线摄影及MSCT对股骨粗隆骨骨折稳定型的准确率,并分析不同检查手段的差异性,采用Kappa指数评价两种诊断方法与手术结果的一致性。结果:80例患者中经X射线检查出46例稳定型,不稳定型34例,与手术结果一致性中等(Kappa=0.606,P<0.05);MSCT检查出52例稳定型,不稳定型28例,与手术结果一致性较高(Kappa=0.861,P<0.05)。MSCT对于股骨粗隆骨骨折的稳定型及不稳定型分型正确检出率为93%(75/80),显著高于X射线检出率,差异有统计学意义(x^(2)=5.714,P<0.05)。结论:MSCT对于股骨粗隆骨骨折的分型更准确且更精准,正确检出率高于X射线检查,对于隐匿性股骨粗隆骨骨折的分型和术前判断有积极意义,更能准确真实的反映出骨折的状态,具有一定的临床应用价值。

Objective:To investigate the application value of multi-slice spiral computed tomography(MSCT)and X-ray in assessing the classification of femoral trochanter fracture and the application value of that.Methods:A total of 80 patients with femoral trochanteric fracture who admitted to hospital were selected.The surgical anatomical classification was used as the gold standard,and the accuracies of X-ray and MSCT in the classification of femoral trochanter fracture were compared.The difference of different examination was analyzed.The Kappa index was used to evaluate the consistency between each diagnostic method and surgical result.Results:The 46 cases of 80 patients were confirmed as stable type and 34 cases of them were confirmed as unstable type as X-ray examination,and the consistency between that and surgical result was moderate(Kappa=0.606,P<0.05).On the other hand,the 52 cases of 80 patients were confirmed as stable type and 28 cases of them were confirmed as unstable type as MSCT examination,and the consistency between that and surgical result was higher(Kappa=0.861,P<0.05).The accuracy of MSCT on the stable type and unstable type of femoral trochanteric fracture was significantly higher than that of X-ray examination(x^(2)=5.714,P<0.05).Conclusion:The MSCT classification is more accurate and precise for the classification of femoral trochanteric fractures,which correct detection rate is significantly higher than that of X-ray examination.It has positive significance for the classification and preoperative judgment of occult femoral trochanter fracture,which can more accurately and truly reflect the state of fracture.It has a certain of clinical application value.