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胫骨平台骨折的临床特点及MRI与CT诊断价值

作者:薛红强 任转勤 田宏哲 习 羽 吴博云 张 坤

所属单位:陕西省宝鸡市中心医院医学影像科(陕西 宝鸡 721008)

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摘要

目的研究MRI与CT诊断胫骨平台 骨折的临床效果。方法 选取我院105例胫 骨平台骨折患者为研究对象,受检者均行 MRI、CT检查,将检查结果与手术病理诊 断结果进行比较,以分析胫骨平台骨折患 者MRI与CT检查特点。结果 两种检测方 式对骨折粉碎、骨折移位、骨缺损、骨 折部位显示效果比较无统计学意义(P> 0.05);手术病理证实B1型27例、B2型20 例、B3型11例、C1型28例、C2型11例、 C3型8例,CT诊断符合率分别为88.89%、 95.00%、100.00%、82.14%、90.91%、 87.50%,与MRI 100.00%、100.00%、 100.00%、92.86%、100.00%、100.00%比 较无统计学意义(P>0.05),但MRI部分 骨型诊断符合率偏高;CT诊断骨折及分 型准确率分别为93.33%、90.48%与MRI诊 断98.10%、97.14%比较较低,其中分型 符合率比较有统计学意义(P<0.05)。结 论 MRI与CT均为胫骨平台骨折诊断有效方 式,两者比较以MRI价值偏高。

Objective To study the clinical effect of MRI and CT in diagnosis of tibial plateau fractures. Methods 105 cases of patients with tibial plateau fractures in the hospital were selected as the research object. All of the subjects received MRI and CT examination. The examination results were compared with the results of surgical and pathological diagnosis to analyze the features of MRI and CT for patients with tibial plateau fractures. Results The differences in the display results of the two kinds of detection methods for comminuted fracture, displacement fracture, bone defect, fracture sites were not statistically significant (P>0.05); surgical pathology confirmed that there were 27 cases of type B1, 20 cases of type B2, 11 cases of type B3, 28 cases of type C1, 11 cases of type C2 and 8 cases of type C3. The diagnose accordance rates of CT diagnosis respectively were 88.89%, 95%, 100.00%, 82.14%, 90.91% and 87.50%. There was no significant difference, compared with 100.00%, 100.00%, 100.00%, 92.86%, 100.00% and 100.00% (P>0.05)but the diagnose accordance rates of MRI diagnosis for parts of the bone types was too high; the accuracy of CT in diagnosis of fracture and classification of types were 93.33% and 90.48% which were relatively lower than 98.10% and 97.14% of MRI diagnosis. The coincidence rate of classification of types was statistically significant (P<0.05). Conclusion MRI and CT were effective ways for diagnosis of tibial plateau fractures, while between the two, the value of MRI was higher.

【关键词】胫骨平台骨折;临床特点; MRI;CT

【中图分类号】R274.1

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.10.032

前言

胫骨平台骨折为常见关节内骨折,常伴有周围组织损伤等情况, 准确诊断骨折分型对治疗有重要意义[1]。以往常用X线进行诊断分型, 但常规X线检查所提供依据较少,对后续治疗的指导意义有限[2]。而随 着影像学技术的不断发展,CT及MRI检查也得到较多应用,而近年高能 损伤发生率上升,胫骨平台骨折病理变化更为复杂,因此有效、准确 的诊断具有重要的临床价值。