磁共振成像联合螺旋CT诊断小儿细微性骨折研究

Accuracy of MRI combined with spiral CT in the diagnosis of fine fracture in children

目的分析磁共振成像(MRI)联合64排螺旋CT诊断小儿细微性骨折的准确率。方法选定郑州市骨科医院2020年1月至2022年1月接诊的75例细微性骨折患儿,分别给予MRI、64排螺旋CT检查,将外科手术作为本次研究诊断金标准,比较MRI、CT、MRI+CT总检出率、诊断准确率、灵敏度及特异度,Kappa检验MRI、CT、MRI+CT与外科手术的一致性。结果MRI+CT(96.0%)、MRI(92.0%)总检出率均高于CT(80.0%),差异有统计学意义(P<0.05)。MRI+CT(98.7%、98.6%)、MRI(93.3%、94.5%)诊断准确率、灵敏度均高于CT(81.3%、82.2%),P<0.05,MRI+CT(100%)、MRI(50.0%)诊断特异度与CT(50.0%)比较,差异无统计学意义(P>0.05),Kappa检验CT与外科手术的一致性一般(Kappa值=0.60),差异有统计学意义(P<0.05),MRI、MRI+CT与外科手术的一致性较好(Kappa值=0.77、0.79),差异有统计学意义(P<0.05)。结论MRI、MRI+64排螺旋CT均可提高对小儿细微性骨折诊断效能,优于CT,但MRI联合64排螺旋CT的准确率、灵敏度相对较高,可为临床诊治患者疾病提供更多准确的参考依据。

Objective To analyze the accuracy of MRI combined with 64-slice spiral CT in the diagnosis of subtle fractures in children.Methods A total of 75 children with subtle fractures who were admitted to Zhengzhou Orthopedics Hospital from January 2020 to January 2022 were selected to receive MRI and 64-slice spiral CT examination,respectively.Surgery was taken as the diagnostic gold standard of this study,and the total detection rate,diagnostic accuracy,sensitivity and specificity of MRI,CT and MRI+CT were compared.Kappa tests the consistency of MRI,CT,MRI+CT and surgical procedures.Results The total detection rate of MRI+CT(96.0%)and MRI(92.0%)was higher than that of CT(80.0%,P<0.05).The diagnostic accuracy and sensitivity of MRI+CT(98.7%,98.6%)and MRI(93.3%,94.52%)were higher than those of CT(81.3%,82.2%,P<0.05).The diagnostic specificity of MRI+CT(100%)and MRI(50.0%)was compared with that of CT(50.0%,P>0.05).Kappa test showed general consistency between CT and surgery(Kappa=0.60,P<0.05).MRI,MRI+CT showed good consistency with surgery(Kappa=0.77,0.79,P<0.05).Conclusion Both MRI and MRI+64-slice spiral CT can improve the diagnostic efficacy of pediatric fine fracture,which is superior to CT.However,the accuracy and sensitivity of MRI+64-slice spiral CT are relatively high,which can provide more accurate reference for clinical diagnosis and treatment of patients with diseases.