X线、CT联合MRI在胫骨平台骨折中的诊断价值

目的探讨X线、CT联合MRI在胫骨平台骨折中的诊断价值。方法回顾性分析我院2017年3月~2019年3月144例（144侧）急诊拟诊胫骨平台骨折患者的临床资料，其中男80例、女64例，年龄20~78岁（52.35±10.49岁）；全部患者在常规行X线检查后，依次行CT及MRI检查。比较单独X线诊断、X线联合CT及三者联合诊断的骨折的符合率及对骨折分型诊断的符合率，并探讨各影像学诊断方式在软组织诊断方面的作用。结果X线＋CT两者联合与X线＋CT＋MRI三者联合诊断胫骨平台骨折符合率比较差异无统计学意义（P>0.05），但均高于单独X线诊断（P<0.05）。X线＋CT与三者联合诊断胫骨平台各骨折分析比较差异无统计学意义（P>0.05）；X线＋CT与三者联合对Ⅰ型、Ⅱ型、Ⅲ型骨折诊断的符合率均高于单独X线诊断，差异有统计学意义（P<0.05）。MRI诊断60例存在软组织损伤，X线及CT未予诊断。结论X线联合CT对胫骨平台骨折的诊断及分型诊断符合率较高，但进一步联合MRI检查可对软组织损伤情况作出判断，具有较好的应用价值。 

Diagnostic value of X-ray and CT combined with MRI in tibial plateau fracture

Objective To explore the diagnostic value of X-ray and CT combined with MRI in tibial plateau fracture. Methods The clinical data of 144 patients(144 sides) with tibial plateau fractures in our hospital from March 2017 to March 2019 were retrospectively analyzed, including 80 males and 64 females with the age from 20 to 78 years old(average 52.35±10.49). All patients were examined by CT and MRI after routine X-ray examination. The coincidence rate of X-ray diagnosis, X-ray combined with CT and three combined diagnoses and the coincidence rate of fracture classification diagnosis were compared.The role of imaging diagnosis methods in soft tissue diagnosis was discussed. Results The difference of the coincidence rate between X-ray+CT and MRI in the diagnosis of tibial plateau fractures was not significant(P>0.05). But the coincidence rate was significantly higher than that of X-ray alone(P<0.05). The difference of the diagnosis of tibial plateau fractures between the two methods and the three methods was not significant(P>0.05). The coincidence rate of the combination of the two and the three in the diagnosis of type I, type II and type III fractures was higher than that of the X-ray diagnosis alone(P<0.05). There were 60 cases of soft tissue injury diagnosed by MRI, but no diagnosis was made by X-ray and CT. Conclusion The coincidence rate of X-ray combined with CT in the diagnosis and classification of tibial plateau fracture is high, but further combined with MRI examination can make a judgment of soft tissue injury.