摘要
目的 研究多层螺旋CT(MSCT)三 维重建技术股骨颈骨折手术中的应用价 值。方法 以本院2013年1月-2015年5月收 治的100例股骨颈骨折患者为研究对象, 均接受X线、MSCT检查,以手术结果为金 标准,比较X线、MSCT三维重建技术对股 骨颈骨折解剖分型、Garden分型的诊断符 合率,另外随访2年,统计骨折不愈合、 股骨头坏死发生率。结果 以手术解剖分 型、Garden分型为标准,MSCT三维重建技 术对股骨颈骨折患者解剖分型、Garden分 型诊断相符率分别为98.00%、100.00%, 均显著高于X线平片的86.00%、82.00%, 差异有统计学意义(P<0.05);术后2年 死亡1例,失访2例,股骨头坏死、骨折不 愈合发生率分别为8.25%、3.09%。结论 MSCT三维重建技术相比X线平片在股骨颈 骨折解剖分型、Garden分型诊断上有明显 优势,可指导手术治疗,减少术后股骨头 坏死、骨折不愈合等并发症发生。
Objective To study the application value of multi-slice spiral CT (MSCT) in femoral neck fracture surgery. Methods One hundred patients with femoral neck fractures treated in our hospital between January 2013 and May 2015 were selected as study subjects and were examined by X-ray and MSCT. With surgical results as the golden standard, the coincidence rates were compared between X-ray and MSCT three-dimensional reconstruction technique in the diagnosis of femoral neck fracture anatomic type and Garden type. After 2 years of follow-up, the incidence rates of fracture nonunion and femoral head necrosis were statistically analyzed. Results With surgical anatomic type and Garden type as criteria, the coincidence rates of MSCT three-dimensional reconstruction technique in the diagnosis of anatomic type and Garden type (98.00% and 100.00%) were significantly higher than those of X-ray films (86.00% and 82.00%) (P<0.05). In 2 years after surgery, there were 1 case died and 2 cases lost to followup, and the incidence rates of femoral head necrosis and nonunion were 8.25% and 3.09% respectively. Conclusion Compared with X-ray plain film, MSCT three-dimensional reconstruction technique has obvious advantages in the diagnosis of femoral neck fractureanatomic type and Garden type, which can guide surgical treatment, reduce postoperative femoral head necrosis, nonunion and other complications.
【关键词】股骨颈骨折;多层螺旋CT;三 维重建技术;X线平片
【中图分类号】R274.1
【文献标识码】A
【DOI】10.3969/j.issn.1672- 5131.2017.06.042
前言
股骨颈骨折好发于老年人群,指的是股骨头至股骨颈基底部间骨 折,骨折线多分布于关节内,近年来受车祸、建筑受伤等影响,青壮 年骨折病例数逐年增多,由于股骨颈骨折解剖结构特殊,其分型在很 大程度上直接关系到患者预后[1]。为此早期正确判断股骨颈骨折及其 分型,对其预后改善具有十分重要的意义。既往临床诊治股骨颈骨 折以X线平片为主要依据,受其解剖结构、患者配合度等影响,常规 X线平面检查难以对骨折情况全面显示,临床应用受限。近年来多层 螺旋CT(MSCT)因其快速扫描、三维重建技术在临床骨折诊治中广泛应 用[2-3],对骨折部位影像学解剖结构可清晰显示,有利于治疗方案制定 及预后评估。基于此,本研究通过与X线平片对照,分析MSCT三维重建 技术对股骨颈骨折解剖分型、Garden分型及预后的评估作用,报道如 下。
中国CT和MRI杂志
第15卷, 第 6 期
2017年06月
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