X线平片与多层螺旋CT在四肢骨关节骨折中的诊断价值

目的探讨X线平片与多层螺旋CT(MSCT)后处理技术在诊断四肢骨关节骨折中的应用价值。方法回顾性分析我院就诊治疗的62例四肢骨关节骨折患者的临床资料进行回顾性整理分析,以手术诊断为标准,总结不同检查方法对四肢骨关节骨折的诊断正确性,分析不同骨关节骨折在不同影像学检查中的图像特征。结果整理临床病例资料可知,X线平片和MSCT后技术处理检查对四肢骨关节骨折检出率分别为83.87%和96.77%,比较差异间无统计学意义(P>0.05),但MSCT后技术处理对四肢骨关节骨折的诊断符合率显著高于X线平片检查,比较差异间具有统计学意义(P<0.05);由资料可知,经X线平片检查符合诊断48例,其余14例显示为可疑及未见异常但是实际上存在着隐匿性骨折,而X线检查中,多数均表现为骨皮质不连续,呈现中断。由于X线平片检查中对于髋臼、髌骨、踝关节后踝、肱骨内上髁、第4、5掌骨基底部中细小骨折线因影像的重叠未能明显显示,故易发生误诊,而在MSCT后处理技术检查中,行MSCT扫描后,再经MPR SSD VRT多方面重建,其中MPR轴位可明显见掌骨基底存在细小骨折线,且对于肱骨内上髁游离的细小骨碎片也可清晰显示。结论 MSCT后处理技术诊断四肢骨关节骨折的正确符合率更高,对于实际在但未能明显表现的隐匿性骨折、骨折部位、位置以及与周围组织关系更能清晰立体的显现,进而更有利于临床医生进行观察和诊断。

The Value of X-ray and Multi-slice Spiral CT in the Diagnosis of Limb Joint Fracture

Objective To explore the application value of post-processing techniques of X-ray plain film and multi-slice spiral CT(MSCT)in the diagnosis of articular fracture of extremities. Methods The clinical data of 62 patients with articular fracture of extremities who were treated in our hospital were retrospectively analyzed. To analyze the image characteristics of fractures of different joint in different imaging examinations. Results According to the clinical data, the The diagnostic accordance rates of post-processing techniques of X-ray plain film and MSCT for articular fracture of extremities were 83.87% and 96.77%, respectively.There was no statistically significant difference between the differences(P>0.05). However, the diagnostic accordance rate of post-processing techniques of MSCT for articular fracture of extremities was significantly higher than that of the X-ray plain film, and the difference was statistically significant(P<0.05). According to the relevant imaging data of 62 patients with articular fracture of extremities, 48 cases were diagnosed by X-ray plain film, and the remaining 14 cases were suspicious and not abnormal, but there were actually occult fractures. In the X-ray examination, most of them showed discontinuous cortical bone, which was interrupted.Because of the overlap of the imagines,fine fracture line in acetabulum,patella, posterior malleolus, epitrochlea and the 4 th and 5 th metacarpal bases can not been shown in the X-ray examination,so the misdiagnosis is easy to occur.In the post-processing technology examination of MSCT, after MSCT scanning, it was reconstructed by MPR, SSD and VRT in many aspects. Among them, the MPR axis can clearly showed the small fracture line in the metacarpal base and the small bone fragments free from the epitrochlea. Conclusion The correct coincidence rate of MSCT post-processing technique in the diagnosis of articular fracture of extremities is higher. It can present the actual but not obvious occult fractures, fracture sites, locations and the relationship with the surrounding tissue in a more clear and stereoscopic way, which is more beneficial for clinicians to observe and diagnose.