三维CT重建在肱骨髁上骨折诊断中的应用

目的分析三维CT重建在肱骨髁上骨折诊断中的应用价值。方法随机选取2016年6月至2018年2月我院收治的48例肱骨髁上骨折儿童为研究对象,均行普通X线检查、常规螺旋CT扫描、三维CT重建,分析其影像特点,并对比三种检查方式对骨折椎节、骨折位置的显示情况及诊断效能。结果 48例均行伤侧肘关节正侧位X线片检查,分为伸直型46例(95.83%),屈曲型2例(4.17%);三维CT重建观察到骨折断端多为粉碎骨折,骨折近端前缘呈"一"形43例,骨折两端完全分离移位,骨皮质不连续,骨折近端前缘呈倒"V"形5例;三维CT重建对骨折椎节、骨折部位的显示率高于X线及常规CT(P<0.05);三维CT重建诊断肱骨髁上骨折的灵敏度、准确度、Kappa值高于X线及常规CT(P<0.05)。结论三维CT重建在肱骨髁上骨折中有较高诊断价值,可较好显示骨折椎节、骨折部位,评估Gartland分型,提高诊断效能,值得在临床推广实践。

Application of Three-dimensional CT Reconstruction in Diagnosis of Supracondylar Fracture of the Humerus

Objective To analyze the value of three-dimensional CT reconstruction in the diagnosis of supracondylar fractures of the humerus. Methods Forty-eight children with supracondylar fracture of the humerus treated in the hospital from June 2016 to February 2018 were selected randomly. All of them underwent conventional X-ray examination, conventional spiral CT scan and three-dimensional CT reconstruction, and imaging characteristics were analyzed. The display of fractured vertebra and fracture location and diagnostic efficiency were compared among the three examination methods. Results All the 48 cases underwent anterioposterior and lateral X-ray examination of the injured side of the elbow, including 46 cases(95.83%) of extension type and 2 cases(4.17%) of flexion type. Three-dimensional CT reconstruction showed that fractures were mostly comminuted fractures. There were 43 cases of one-shape proximal anterior edge of the fracture. The two ends of the fracture were completely dislocated and displaced. The cortical bone was discontinuous, and the proximal edge of the fracture showed an inverted V shape in 5 cases. The display rates of fractured vertebra and fracture location by tree-dimensional CT reconstruction was higher than those by X-ray or conventional CT(P<0.05). The sensitivity, accuracy and Kappa value of three-dimensional CT reconstruction in the diagnosis of supracondylar fracture of the humerus were higher than those of X-ray or conventional CT(P<0.05). Conclusion Three-dimensional CT reconstruction is of high diagnostic value in supracondylar fractures of the humerus. It can better display the fractured vertebra and fracture location, evaluate Gartland classification, and improve the diagnostic efficiency.