不同影像学检查在髋臼骨折诊断中的价值

目的探讨X线片、CT平扫及CT三维重建在髋臼骨折诊断中的价值。方法1997年11月～2004年3月对74例髋臼骨折患者拍前后位、多方位即闭孔斜位、髂骨斜位、骨盆出、入口位X线片,其中57例行CT平扫,17例行CT三维重建。分别计算并比较各种方法对髋臼骨折的检出率,同时根据影像学所见进行诊断、分型,并在术中验证得出分型符合率后进行对比。结果骨折检出率:前后位X线片为90.54%,多方位X线片为97.30%,CT平扫为98.25%,CT三维重建为100%;其分型符合率分别为41.79%,97.22%,100%,100%。结论传统的前后位与多方位X线片为髋臼骨折诊断中经济实用的首选方法,CT平扫与三维重建可提高诊断率,并对准确分型、制定合理的治疗方案起关键作用。

Values of different radiographies in diagnosis of acetabular fractures

Objective To compare the values of X radiograph, CT scan and 3 D CT reconstruction in the diagnosis of acetabular fractures. Methods 74 cases of acetabular fractures were examined by pelvic APV (anterioposterior view) and multi orientation views including OOV (obturator oblique view), IOV (ilium oblique view), PIV (pelvis inlet view) and POV (pelvis outlet view)from November 1997 to March 2004. Among them, 57 cases were checked by CT scan, 17 cases were photographed by 3 D CT reconstruction. The detection rates of fractures by various methods were calculated and compared respectively. The diagnosis and typing of fractures made through radiographic examinations were compared with those verified during operation to calculate the respective agreement rates. Results The detection rates of fractures by APV, multi orientation view, CT scan and 3 D CT reconstruction were 90.54% , 97.30% , 98.25% and 100% ; and their agreement rates were 41.79% , 97.22% , 100% and 100% respectively. The differences were statistically significant. Conclusions Being economical and practical, traditional APV and multi orientation views should still be the first choice for the diagnosis of acetabular fractures. CT scan and 3 D CT reconstruction can enhance the precise diagnostic rate and play a critical role in accurate typing and reasonable therapeutic scheme. [