多层螺旋CT三维重建与X线评估老年股骨颈骨折分型、股骨颈移位程度价值的研究

Study on the Value of Multi-slice Spiral CT Three-dimensional Reconstruction and X-ray in Evaluating the Classification of Femoral Neck Fracture and the Degree of Femoral Neck Displacement in the Elderly

目的观察多层螺旋CT三维重建与X线评估老年股骨颈骨折分型、股骨颈移位程度的价值。方法选取2021年7月-2023年4月我院诊治的63例老年股骨颈骨折患者为研究对象,均采用X线、多层螺旋CT三维重建技术,比较不同检查方法Garden分型符合率、FNF解剖分型符合率、Garden分型诊断效能(灵敏度、特异度、准确率、阳性预测值、阴性预测值)、股骨颈骨折Garden分型诊断准确率与术后病理结果的一致性。结果多层螺旋CT三维重建诊断老年股骨颈骨折Garden分型符合率为96.83%,高于X线诊断符合率的80.95%(P<0.05);多层螺旋CT三维重建诊断老年股骨颈骨折FNF解剖分型符合率为95.24%,高于X线诊断符合率的69.84%(P<0.05);多层螺旋CT三维重建对股骨颈骨折Garden分型诊断灵敏度、特异度、准确率、阴性预测值均高于X线诊断患者(P<0.05),但不同检查方法间阳性预测值比较,差异无统计学意义(P>0.05);多层螺旋CT三维重建诊断股骨颈骨折Garden分型准确率与术后病理结果具有高度一致性,且一致性高于X线检查患者(P<0.05)。结论多层螺旋CT三维重建诊断老年股骨颈骨折分型、股骨颈移位程度价值高于X线,可提高诊断效能,获得与手术病理诊断基本一致的结果,利于临床治疗方法的制定,值得临床加以应用。

Objective To observe the value of multi-slice spiral CT three-dimensional reconstruction and X-ray in evaluating the classification of femoral neck fracture and the degree of femoral neck displacement in the elderly.Methods A total of 63 elderly patients with femoral neck fracture diagnosed and treated in our hospital from July 2021 to April 2023 were selected as the research objects.All patients were examined by X-ray and multi-slice spiral CT three-dimensional reconstruction.The coincidence rate of Garden classification,the coincidence rate of FNF anatomical classification,the diagnostic efficacy(sensitivity,specificity,accuracy,positive predictive value,negative predictive value)of Garden classification,and the diagnostic accuracy of Garden classification of femoral neck fracture were compared with the postoperative pathological results.Results The coincidence rate of Garden classification of femoral neck fracture in the elderly diagnosed by multi-slice spiral CT three-dimensional reconstruction was 96.83%,which was higher than 80.95% of X-ray diagnosis(P<0.05).The coincidence rate of multi-slice spiral CT three-dimensional reconstruction in the diagnosis of FNF anatomical classification of femoral neck fracture in the elderly was 95.24%,which was higher than 69.84% of X-ray diagnosis(P<0.05).The sensitivity,specificity,accuracy and negative predictive value of Garden classification of femoral neck fracture diagnosed by multi-slice spiral CT three-dimensional reconstruction were higher than those diagnosed by X-ray(P<0.05),but there was no significant difference in positive predictive value between different examination methods(P>0.05).The accuracy of Garden classification of femoral neck fracture diagnosed by multi-slice spiral CT three-dimensional reconstruction was highly consistent with postoperative pathological results,and the consistency was higher than that of X-ray examination(P<0.05).Conclusion The value of multi-slice spiral CT three-dimensional reconstruction in the diagnosis of femoral neck fracture classification and femoral neck displacement in the elderly is higher than that of X-ray,which can improve the diagnostic efficiency and obtain the results basically consistent with the surgical pathological diagnosis.Meanwhile,it is conducive to the formulation of clinical treatment methods and is worthy of clinical application.