MRI与MSCT在膝关节隐匿性骨折中的应用

目的对比MRI与多层螺旋CT(MSCT)对膝关节隐匿性骨折的诊断效果。方法回顾性分析2017年5月—2019年5月我院158例经手术或关节镜确诊的隐匿性膝关节骨折患者的临床资料。158例患者均采取MRI与MSCT检查,观察膝关节隐匿性骨折的MSCT与MRI征象。同时,比较MSCT与MRI的诊断的符合率,以及诊断的灵敏度、特异度、阳性预测值、阴性预测值。结果MSCT检查:骨折线影或骨质呈持续性中断,局部骨质缺损与移位骨折吻合。MRI检查:T1WI序列呈片状略低或不均匀低信号,T2WI序列则为略高或高信号,STIR序列边缘欠清晰,呈高信号,各序列像未见明显的线样略高信号或低信号。本组患者经MRI诊断的符合率99.17%高于MSCT90.00%(P<0.01),且诊断的灵敏度、特异度、阳性预测值与阴性预测值均高于MSCT,结果对比差异具有统计学意义(P<0.05)。结论相较于MSCT,MRI对膝关节隐匿性骨折的诊断效果更为理想,所以对于X线诊断为阴性且高度疑似膝关节隐匿性骨折的患者,应及时给予MRI检查,以便保障后续治疗效果。

Application of MRI and MSCT in occult fracture of knee joint

Objective To compare the effect of MRI and MSCT in the diagnosis of occult fracture of knee joint.Methods The clinical data of 158 patients with occult knee fracture confirmed by operation or arthroscopy in our hospital from May 2017 to May 2019 were analyzed retrospectively.MRI and MSCT were used in 158 patients to observe the MSCT and MRI signs of occult fracture of knee joint.At the same time,the diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of MSCT and MRI were compared.Results MSCT examination:showed that the fracture line shadow or bone was interrupted continuously,and the local bone defect was consistent with the displaced fracture.MRI examination:T1WI sequence showed slightly low or uneven low signal,T2WI sequence showed slightly high or high signal,the edge of STIR sequence was not clear,showing high signal,no obvious line like slightly high or low signal was found in each sequence.The coincidence rate of MRI diagnosis in this group was 99.17%higher than that of MSCT 90.00%(P<0.01),and the sensitivity,specificity,negative predictive value and positive predictive value of the diagnosis were higher than those of MSCT,the difference was statistically significant(P<0.05).Conclusion Compared with MSCT,MRI is more effective in the diagnosis of occult fracture of knee joint.Therefore,MRI should be given to patients with negative X-ray diagnosis and highly suspected occult fracture of knee joint in time to ensure the follow-up treatment effect.