X线数字化断层融合成像在腓骨骨折及其分型中的诊断价值分析

Analysis of diagnostic value of X-ray digital tomography fusion imaging in fibular fractures and their classification

目的探讨分析X线数字化断层融合成像(X-ray digital tomography fusion imaging,DTS)在腓骨骨折及其分型中的诊断价值。方法采用回顾性研究方法选取2020年9月至2021年9月四川省骨科医院收治的95例疑似腓骨骨折患者的临床资料,对全部患者行数字化X线摄影(digital X-ray photography,DR)、DTS和计算机断层扫描(computed tomography,CT)检查,并以CT检查结果作为金标准,采用kappa一致性对比分析DR与DTS对腓骨骨折及其分型的诊断效能。结果CT结果示骨折57例,未骨折38例,其中腓骨骨折线距腓骨尖以下的骨折26例,平于腓骨骨折线距腓骨尖及以上的骨折31例。DTS诊断腓骨骨折的特异度(78.95%)高于DR(65.96%),差异有统计学意义(χ^(2)=4.04,P=0.044),并且DTS的kappa值(0.775)>DR的kappa值(0.529)。DTS对腓骨骨折分型诊断的灵敏度(96.15%)及特异度(92.75%)均高于DR(73.08%和88.41%),组间比较差异均有统计学意义(χ^(2)值分别为26.10、45.32,均P<0.001);并且DTS对腓骨骨折分型的kappa值(0.848)>DR的kappa值(0.608)。结论DTS对腓骨骨折及其分型的诊断效果优于DR,值得在临床广泛推广应用。

Objective To explore and analyze the diagnostic value of X-ray digital tomography fusion imaging(DTS)in fibular fractures and their classification.Methods A retrospective study was conducted to select 95 suspected fibular fracture patients admitted to Sichuan Orthopedic Hospital from September 2020 to September 2021 Digital X-ray photography(DR),DTS,and computed tomography(CT)were performed on all patients,and the CT results were used as the gold standard.Kappa consistency was used to compare the diagnostic efficacy of DR and DTS for fibular fractures and their classification.Results CT results showed 57 cases of fractures and 38 cases of non fractures.Among them,there were 26 cases of fractures below the fibular apex on the fibular fracture line,and 31 cases of fractures above the fibular apex on the fibular fracture line.The specificity of DTS in diagnosing fibular fractures(78.95%)was higher than DR(65.96%),with a statistically significant difference(χ^(2)=4.04,P=0.044),and the kappa value of DTS(0.775)was greater than that of DR(0.529).The sensitivity(96.15%)and specificity(92.75%)of DTS in the classification diagnosis of fibular fractures were higher than DR(73.08% and 88.41%),and the intergroup differences were statistically significant(χ^(2)=26.10,45.32,P<0.001).The kappa value(0.848)of DTS for the classification of fibular fractures is greater than DR(0.608).Conclusion The diagnostic effect of TS on fibular fractures and their classification is superior to DR,and it is worth promoting and applying widely in clinical practice.