MSCT对儿童肘关节骨骺及骺板损伤的诊断价值

Diagnostic value of MSCT in elbow epiphyseal and epiphyseal plate injury in children

目的探讨多排螺旋CT(MSCT)对儿童肘关节骨骺损伤的诊断价值。方法对经手术或影像学证实的118例儿童急性肘关节骨骺及骺板损伤患儿先后行X线片和MSCT检查,分析影像学征象,采用χ2检验比较X线片和MSCT对儿童肘关节骨骺及骺板损伤的诊断准确率。结果 118例儿童急性肘关节骨骺及骺板损伤,按Salter-Harris法分型:Ⅰ型8例、Ⅱ型45例、Ⅳ型65例;X线片诊断准确率为80.5%(95/118),MSCT诊断准确率为97.5%(115/118),差异有统计学意义(P<0.05),20例X线阴性者MSCT有阳性发现。结论 MSCT较X线对肘关节骨骺及骺板损伤具有更高的敏感性和准确性,能提供更多信息,减少X线漏诊或误诊,并对肘关节隐匿性骨折及复杂性骨折进行准确的诊断,指导临床医生对肘关节骨骺及骺板损伤的术前分析。

Objective To explore the diagnostic value of Multi-slice Computed Tomography(MSCT) in elbow epiphyseal injury in children. Methods A total of 118 cases of children's elbow epiphyseal injuries which confirmed by surgery or imageology were examined by X-ray and MSCT, and were recnstructed by MPR, VR, then were analyzed the imageological characteristics. Results In 118 cases, 8 cases were Type I, 45 cases were Type II, 65 cases were Type IV; the accuracy rate of diagnosis of MSCT were 97.5%(115/118), the accuracy rate of diagnosis of X-ray were 80.5%(95/118). In 20 cases, MSCT showed positive, which X-ray showed negative. Conclusion MSCT has higher sensitivity and accuracy than X-ray in diagnosing elbow epiphyseal and epiphyseal plate injury. It can provide more information, reduce missed diagnosis or misdiagnosis of X-ray, and diagnose elbow occult fracture and complicated fracture, then guide the clinician to analyze elbow epiphyseal and epiphyseal plate injury before operation.