目的 分析多层螺旋CT及三维重 建在胫骨平台骨折诊断与分型中的应用价 值。方法 选择2012年5月-2015年6月于我 院经手术证实为胫骨平台骨折的71例患 者，所有患者均拍摄膝关节正侧位DR(数 字X线摄影)平片，已接受多层螺旋CT检 查，与手术结果对照，比较不同影像学 检查方法对胫骨平台骨折诊断及分型价 值。结果 CT对Ⅰ型、Ⅱ型、Ⅳ型、Ⅴ型 胫骨平台骨折分型准确率均略高于DR检 查，但对比差异无统计学意义(P>0.05)， CT分型整体准确率为94.4%，高于DR的 77.5%(P<0.05)；CT骨折检出率为95.8%， 高于DR的85.9%(P<0.05)；DR对髁间隆 突骨折检出率为70.4%，低于CT的96.3% （P<0.05），DR对腓骨小头骨折检出率为 65.0%，同样低于CT的95.0%(P<0.05)。结 论 采用多层螺旋CT配合三维重建技术诊 断胫骨平台骨折，骨折检出率高，分型符 合度高，对合并腓骨小头骨折与髁间隆突 骨折诊断敏感度好。

Objective To analyze the application value of multi-slice spiral CT and threedimensional (3D) reconstruction in the diagnosis and typing of tibial plateau fractures. Methods 71 patients with tibial plateau fractures confirmed by operation in our hospital between May 2012 and June 2015 were enrolled in the study. All patients were taken DR (digital radiography) plain film of the adem position of knee joint. Besides, they had undergone multi-slice spiral CT examination and compared with the operation results. The value of different imaging methods in the diagnosis and typing of tibial plateau fractures was compared. Results The accuracy rates of CT in typing of type I, type II, type IV and type V tibial plateau fractures were slightly higher than those of DR but the differences was not significant (P>0.05). The overall accuracy rate of CT typing (94.4%) was higher than that of DR (77.5%) (P<0.05). The detection rate of CT for fractures (95.8%) was higher than that of DR (85.9%) (P<0.05). The detection rate of DR for intercondylar eminence fractures (70.4%) was lower than that of CT (96.3%) (P<0.05). The detection of DR for fibular fractures (65.0%) was also lower than that of CT (95.0%) (P<0.05). Conclusion To apply multislice spiral CT combined with 3D reconstruction technique in the diagnosis of tibial plateau fractures, the detection rate of fractures is high and coincidence rate of typing is also high. The sensitivities in diagnosis of complicated fibular fractures and intercondylar eminence fracture are good.