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MSCT与MRI诊断细微及隐匿性骨折中的阳性率和特异性对比研究

作者:田文敏

所属单位:冀中能源峰峰集团总医院放射科(河北 邯郸 056200)

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摘要

目的探讨研究MSCT与MRI诊断 细微及隐匿性骨折中的阳性率和特异 性。方法 选取我院超声科收治的180例 细微及隐匿性骨折患者,分别采用MSCT 和MRI对骨折部位进行检测诊断,对比 两种检测方法的检出结果、阳性率和特 异性。结果 MSCT细微及隐匿性骨折检 出率为85.56%,MRI检查结果显示检出 率为96.67%,差异具有显著统计学意 义(P=0.000);MSCT在检测衰竭骨折、 疲劳骨折、隐性创伤骨折方面特异度较 MRI稍高,差异不具有统计学意义(P> 0.05),在检测隐性股内骨折方面特异度 (74.29%)和MRI(94.29%)差异具有统计 学意义(P=0.049)。结论 采用MSCT和MRI 在诊断细微及隐匿性骨折方面均具有一定 的应用价值,但是MRI检出率和特异度较 高,可以为临床鉴定和治疗提供更可靠的 数据。

Objective To investigate the positive rate and specificity of MSCT and MRI in diagnosis of subtle and occult fractures. Methods 180 cases of subtle and occult fracture patients were selected from our hospital, and the diagnosis was made by MRI and MSCT respectively. The results of the two detection methods were compared. Results The detection rate of MSCT and occult fracture was 85.56%, and the detection rate of MRI was 96.67%, the difference was statistically significant (P=0.000).The specificity of MSCT in the detection of failure fracture, fatigue fracture and occult fracture is higher than MRI,but the difference was not statistically significant (P>0.05),which was statistically significant (P=0.049) in specificity of the detection of the hidden fractures in the stock of MRI (74.29%) and MSCT (94.29%). Conclusion Both MSCT and MRI have certain application value in the diagnosis of subtle and occult fractures, but the detection rate and specificity of MRI can provide more reliable data for clinical evaluation and treatment.

【关键词】多层螺旋CT;核磁共振成像;细微及隐匿性骨折;阳性率;特异性

【中图分类号】R445.2;R683

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2015.12.038

前言

细微及隐匿性骨折是指骨折断裂不明显,不彻底,无典型临床特 异性体征,又称微型骨折。依据细微及隐匿性骨折的发病机制和临床 治疗方法可以将其分为4个类型,分别是衰竭骨折、疲劳骨折、隐性创 伤骨折和隐性股内骨折[2]。膝关节隐匿性骨折在临床上较为常见,患 者往往无明显异常表现,X线片检查结果通常为阴性,极易出现漏诊情 况,延误治疗时机,最终引发软骨缺损、疼痛,严重者甚至出现退行 性骨关节病等后遗症,严重影响患者的生活。随着医疗水平的提高, MSCT和MRI在骨科检查中的应用越来越广泛,相较于X线平片检查,具 有更高的特异性。相关研究表明[3],应用X线片、CR和DR对细微及隐匿 性骨折患者的检查结果显示并未见骨折征象,但是MSCT和MRI检查结果 确实显示存在骨折。为了探讨MSCT与MRI诊断细微及隐匿性骨折中的阳 性率和特异性,并对比二者的优势和应用价值,对180例患者采用对照 方法进行研究,具体情况如下。