多层螺旋CT三维重建与磁共振成像在诊断膝关节隐匿性骨折中临床价值对比

Comparison of the Clinical Value of MSCT Three-Dimensional Reconstruction and MRI in the Diagnosis of Occult Knee Fractures

目的:探讨多层螺旋CT(MSCT)三维重建与磁共振成像(MRI)在膝关节隐匿性骨折中的诊断效果。方法:选取2019年9月~2020年9月本院收治的87例疑似关节隐匿性骨折患者。对所有患者均施以MSCT三维重建与MRI检查,以手术病理检查为膝关节隐匿性骨折诊断的“金标准”,比较两种检查方式的膝关节隐匿性骨折检出情况、诊断效能。结果:MRI膝关节隐匿性骨折检出率高于MSCT三维重建,差异有统计学意义(P<0.05);MRI在膝关节隐匿性骨折诊断中灵敏度87.65%(71/81)、准确度85.06%(74/87)高于MSCT三维重建的71.60%(58/81)、68.97%(60/87),差异有统计学意义(P<0.05);两种检查的特异度相当,差异无统计学意义(P>0.05)。MSCT三维重建与MRI联合诊断膝关节隐匿性骨折的灵敏度97.53%(79/81)、准确度95.40%(83/87)均高于MSCT三维重建、MRI单独诊断(P<0.05)。结论:MRI在膝关节隐匿性骨折中检出率较高,具有较高的灵敏度、准确度,可为膝关节隐匿性骨折患者的治疗提供一定依据,CT三维重建与MRI联合诊断可进一步提升诊断准确性和灵敏度,并可大幅度提升诊断特异度,可为患者临床诊疗提供可靠的参考资料。

Objective:To investigate the diagnostic effect of multi-slice spiral CT(MSCT)three-dimensional reconstruction and magnetic resonance imaging(MRI)in occult knee fractures.Methods:A total of 87 patients with suspected joint occult fractures admitted to our hospital from September 2019 to September 2020 were selected.All patients were subjected to MSCT three-dimensional reconstruction and MRI examination,and surgical and pathological examination was used as the“gold standard”for the diagnosis of occult knee fractures.Results:The detection rate of occult knee fractures on MRI was higher than that on MSCT three-dimensional reconstruction,with a statistically significant difference(P<0.05);The sensitivity and accuracy of MRI in the diagnosis of knee joint occult fractures were 87.65%(71/81)and 85.06%(74/87),which were higher than those of MSCT three-dimensional reconstruction 71.60%(58/81)and 68.97%(60/87),with statistical significance(P<0.05);The specificity of the two tests was comparable,and the difference was not statistically significant(P>0.05).The sensitivity and accuracy of the combination of MSCT three-dimensional reconstruction and MRI in diagnosing occult knee fractures were 97.53%(79/81)and 95.40%(83/87),respectively,higher than those of MSCT three-dimensional reconstruction and MRI alone(P<0.05).Conclusion:MRI has a high detection rate,high sensitivity and accuracy in knee occult fractures,which can provide a certain basis for the treatment of patients with knee occult fractures.The combined diagnosis of CT three-dimensional reconstruction and MRI can further improve the accuracy of diagnosis.It can greatly improve the specificity of diagnosis,and can provide reliable reference materials for clinical diagnosis and treatment of patients.