MSCT三维骨重建技术在髋关节骨折诊断及治疗中的应用

Application of MSCT Three-dimensional Bone Reconstruction in the Diagnosis and Treatment of Hip Fracture

目的探讨多排螺旋CT(MSCT)三维骨重建技术在髋关节骨折诊断及治疗中的应用。方法选择2020年1月~2022年8月我院收治98例髋关节骨折患者,均行常规X线检查和MSCT检查,并进行MSCT三维重建,观察X线片、二维MSCT图像和MSCT骨三维重建图像。结果手术显示,98例患者共发现101处髋中骨折,其中35处为股骨头骨折,24处为股骨颈骨折,21处为粗隆间骨折,21处为髋臼骨折。X线漏检12处骨折,二维CT漏检7处骨折,MSCT三维骨重建未见漏检,其对髋关节骨折检出率显著高于X线及二维CT(P<0.05)。MSCT三维重建对髋臼骨折分型正确检出率高于二维CT和X线,但比较差异未见统计学意义(P>0.05)。根据患者术前MSCT骨三维重建资料设计治疗方案,术中所见与资料吻合,患者手术时间(106.30±27.40)min,术中出血量(356.60±54.17)mL,术中透视时间(21.35±5.11)s,骨折愈合时间(80.46±12.29)d;术后随访显示治疗优良率为94.90%,且暂未发生并发症。结论MSCT三维骨重建可清晰显示髋关节骨折情况,有利于髋关节骨折及骨折分型诊断,对临床手术方案制定及术后关节功能恢复具有重要价值。

Objective To investigate the application of multi-slice spiral CT(MSCT)three-dimensional bone reconstruction in the diagnosis and treatment of hip fractures.Methods 98 patients with hip fracture admitted to the hospital from January 2020 to August 2022 were selected.All patients underwent conventional X-ray examination,MSCT and MSCT bone reconstruction,and the images were observed.Results Surgical results showed that there were 101 hip fractures in the 98 patients,including 35 femoral head fractures,24 femoral neck fractures,21 intertrochanteric fractures and 21 acetabular fractures.X-ray missed 12 fractures,two-dimensional CT missed 7 fractures,and MSCT three-dimensional bone reconstruction detected all fractures.The detection rate of hip fracture was significantly higher than that of X-ray and two-dimensional CT(P<0.05).The accuracy of acetabular fracture classification by MSCT three-dimensional reconstruction was higher than that by two-dimensional CT or X-ray,but the difference was not statistically significant(P>0.05).The treatment plan was developed according to preoperative MSCT three-dimensional bone reconstruction data.The intraoperative findings were consistent with the data.The operation time,intraoperative blood loss,intraoperative fluoroscopy time and fracture healing time were(106.30±27.40)min,(356.60±54.17)mL,(21.35±5.11)s and(80.46±12.29)d.Postoperative follow-up showed that the excellent and good rate of treatment was 94.90%,and no complications were observed.Conclusion MSCT three-dimensional bone reconstruction can clearly show the situation of hip fracture,which is beneficial to the diagnosis of hip fracture and fracture types.It is of great value for the development of clinical surgical plan and postoperative joint function recovery.