X线和CT检查在骨盆损伤中的诊断价值分析

目的比较X线和CT检查在不同类型骨盆损伤中的诊断准确率。方法自2009年1月～2011年1月对65例骨盆损伤行骨盆前后位X线片和CT检查患者进行回顾性研究,由2位创伤骨科医生进行独立分析,并不告知患者的损伤机制,体格检查、临床治疗等相关情况以及所有CT重建资料。要求读片者就每张X线片给出:①损伤的结构;②骨盆骨折的AO分型。再由另外2位创伤骨科具有高级职称的医师就这65例X线片和CT,结合损伤机制、体格检查等临床资料和二维、三维CT重建资料,手术情况,确定损伤的结构、AO分型,作为标准答案。将两次结果进行比较性研究。结果骨盆前后位X线片对于A、B、C型骨折的诊断率分别为:92.9%、38.9%,66.7%。而CT平扫对于A、B、C型骨折的诊断率分别为:85.7%,100%,100%。结论骨盆X线片联合CT检查可最大限度地提高骨盆骨折诊断的准确性,对骨折的分型和稳定性的判断具有较高的敏感性。

Diagnostic value of X-ray and CT scan in pelvic injury

Objective To compare the X-ray and CT scan in diagnosis of different types of pelvic injury.Methods Between Jan.2009 and Jan.2011,65 patients with pelvic injury were retrospectively studied.Two trauma specialists who were not informed of the patients’ mechanisms of injury,physical examination,clinical related information and all the CT reconstruction analyzed the X rays independently.They were asked to tell by reading the films: damage structures and the AO classification of pelvic fractures.The other two senior trauma specialists determined the structural damage,AO classification,as a "standard answer".Combined with the mechanisms of injury,physical examination,the other clinical information,two or three-dimensional CT scan,reconstruction data,and surgery.The results of two studies were compared.Results The diagnostic accuracy of pelvic anteroposterior X-rays in A,B,C-type fracture according to AO classification were 92.9%,38.9%,66.7% respectively.The diagnostic accuracy of CT scan in A,B,C-type fracture were 85.7%,100%,100%.Conclusion Combination of the pelvic X-ray with CT scan can maximize the diagnostic accuracy and the sensitivity for the fracture type and stability in pelvic fracture.