论著-头颈部
MSCT临床应用于肌健、韧带闭合性损伤的诊断价值分析与评价
作者:徐德利1 林 浩1 陶海鹰2
所属单位:1.湖北省武汉市东西湖区人民医院骨外科(湖北 武汉 430040) 2.武汉大学湖北省人民医院骨科(湖北 武汉 430060)
PDF摘要
目的研究多层螺旋CT在肌健、 韧带闭合性损伤临床诊断中的应用价值。 方法 选取我院骨科收治的韧带损伤或 (和)肌腱闭合性损伤患者共100例,作为 观察组;另将100例健康者作为健康组。 所有入选对象均接受16层螺旋CT扫描,并 将观察组扫描结果与手术结果比较,对比 损伤膝关节后交叉韧带与正常膝关节后交 叉韧带的多层螺旋CT影像特征。结果 与 手术结果比较,多层螺旋CT诊断肌腱损伤 正确率为71.15%,诊断韧带损伤正确率为 93.75%。与健康组膝关节后交叉韧带多层 螺旋CT影像特征相比,损伤的膝关节后交 叉韧带角、厚度更小,长径更短,均为P <0.05,差异有统计学意义。本次CT检查 显示肌腱损伤患者均存在肌腹肿胀、肌腱 迂曲、肌腱增粗等表现,韧带损伤患者均 存在韧带迂曲、边界模糊、增粗、关节腔 积液等表现。结论 多层螺旋CT为肌腱、 韧带闭合性损伤的重要诊断手段,诊断正 确率较高;通过淤血、水肿等情况显示损 伤范围及程度,是否有关节腔积液,为临 床诊断与治疗提供有力依据,可作为该类 损伤的首选诊断方法。
Objective This paper is to investigate the application value of multi-slice CT in clinical diagnosis of muscle and ligament closed injuries. Methods A total of 100 patients with tendon injuries or (and) ligament closed injuries admitted by the Orthopaedics Department of the Hospital were selected into the observation group, and another 100 healthy candidates were selected into the health group. All candidates underwent 16- slice spiral CT scanning, and scanning results was compared to surgical results of patients, multi-slice CT imaging features of posterior cruciate ligament with injured kneel joints and those of posterior cruciate ligament with normal knee joints were compared. Results The accuracy of multilayer spiral CT in the diagnosis of tendon injuries hit 71.15% in the comparison in surgical results, and the accuracy in diagnosis of ligament damage hit 93.75%.Compared to multi-slice CT imaging characteristics of post cruciate ligament in the health group, the post cruciate ligament angle of injured kneel joint with smaller thickness and shorter lathy diameter satisfied P < 0.05, and the differences were statistically significant. The results of CT examinations showed that patients with muscle tendon injuries suffered from abdominal symptoms including the swelling, tendon circuity, tendon thickening and patients with ligament injuries suffered from ligament circuity, fuzzy and thickened boundary, articular cavity effusion and other symptoms. Conclusion MSCT acts important diagnosis means for tendon and ligament closed injuries, it delivers diagnostic accuracy, it shows the scope and degree of congestion and edema and the availability of joint cavity effusion, and provides powerful basis for clinical diagnosis and treatment, being preferred diagnostic method of such injury.
【关键词】肌腱损伤;韧带闭合性损伤; 多层螺旋CT;诊断价值
【中图分类号】R686;R445.3
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.09.008
前言
交通事故、生产事故导致的韧带损伤、骨关节肌腱损伤日益增 多。以往韧带损伤及骨关节肌腱闭合性损伤多依靠MRI检查、临床症状 观察,甚至需要进行手术探查,但是MRI检查费用较高,临床表现缺乏 依据,手术探查伤害大[1]。multi-slice computed tomography即多层 螺旋CT(MSCT)技术不断发展,其在韧带及骨关节肌腱闭合性损伤中的 诊断价值逐渐被认可。笔者于2010年1月至2015年2月选取100例肌腱损 伤或(和)韧带闭合性损伤患者,以及100例健康者作为研究对象,以研 究CT应用在肌腱损伤、韧带闭合性损伤诊断中的价值。现将研究结果 进行报道。
中国CT和MRI杂志
第13卷, 第 9 期
2015年09月
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