目的 探讨64层螺旋CT诊断膝关 节创伤后隐匿病变及软组织损伤的临床 价值。方法 以我院诊治的膝关节创伤患 者100例为研究对象，均行X线、64层螺 旋CT检查，其中X线疑为胫骨平台骨折病 例55例，比较两种方法对膝关节胫骨平 台骨折的诊断效能，并对比X线、64层螺 旋CT对各型胫骨平台骨折检出率，分析 两种检查方法下骨折塌陷程度、水平错 位显示程度及影像学特点。结果 本组 100例膝关节创伤患者中55例疑为胫骨 平台骨折，占55.00%；64层螺旋CT诊断 胫骨平台骨折的灵敏度80.00%、准确度 70.00%明显高于X线60.00%(P＜0.05)， 而特异度78.18%、60.00%比较差异无 统计学意义(P＞0.05)；64层螺旋CT对 Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ型胫骨平台骨 折的检出率略高于X线，对Ⅰ-Ⅵ型的总 检出率86.67％明显高于X线60.00％(P ＜0.05)；64层螺旋CT对骨折塌陷程度、 水平错位程度检出率(42.22%、48.89%) 高于X线(17.78%、13.33%)(P＜0.05)； 64层螺旋CT对胫骨平台骨折隐匿病变、 软组织损伤的显示较X线好。结论 与X线 相比，64层螺旋CT在膝关节骨折辅助诊 断中更有优势，通过多平面、多角度成 像更好显示创伤后隐匿病变及软组织损 伤，提高诊断灵敏度、准确度，有较高 推广价值。

Objective To study the clinical value of 64 slice spiral CT in the diagnosis of occult lesions and soft tissue injury after knee trauma. Methods A total of 100 patients with knee trauma treated in the hospital from April 2015 to July 2017 were selected as study subjects. All patients were examined with X-ray and 64 slice spiral CT, and X-ray diagnosed 55 patients with suspected tibial plateau fractures. The diagnostic efficiencies were compared between the two methods for tibial plateau fractures. The detection rates of tibial plateau fractures were compared between X-ray and 64 slice spiral CT. The display and imaging findings of the two examination methods for collapse degree of fractures and horizontal dislocation were analyzed. Results Of 100 patients with knee trauma, 55 patients had suspected tibial plateau fractures, accounting for 55.00%. The sensitivity and accuracy of 64 slice spiral CT in the diagnosis of tibial plateau fractures (80.00%, 70.00%) were significantly higher than those of X-ray (60.00%, 60.00%) (P ＜0.05), while the specificity showed no significant difference between the two methods (78.18% vs 60.00%) (P＞0.05). The detection rates of 64 slice spiral CT in type I, II, III, IV, V and VI tibial plateau fractures were slightly higher than those of X-ray, and total detection rate (86.67%) was significantly higher than that of X-ray (60.00%) (P＜0.05). The detection rates of the collapse degree of fractures and horizontal dislocation by 64 slice spiral CT (42.22%, 48.89%) were higher than those of X-ray (17.78%, 13.33%) (P ＜0.05). 64 slice spiral CT was superior to X-ray in the display of occult lesions and soft tissue injury in tibial plateau fractures. Conclusion 64 slice spiral CT has more advantages over X-ray in the diagnosis of knee joint fractures. It can well display post-traumatic occult lesions and soft tissue injury through multi-plane and multi-angle imaging, and improve the diagnostic sensitivity and accuracy.