目的 探讨基层医院膝关节外伤 多层螺旋CT(Multi Slice Helical CT, MSCT)的应用价值。方法 收集2016年1月 至2018年9月我院诊治疑膝关节骨折的病 例60例，通过MSCT检查后，利用后处理重 建，调节适当的窗宽、窗位、限制膝关节 各组成骨折(包括微小骨折)、韧带损伤、 半月板损伤、关节积液或积血、软组织挫 伤情况等，进行膝关节骨折的分型，与外 科手术病理结果对照，计算诊断准确率、 敏感性、阳性预测值、阴性预测值。结 果 60例膝关节外伤患者中，Schatzker分 型法Ⅰ型10例，Ⅱ型12例，Ⅲ型16例，Ⅳ 型5例，Ⅴ型8例，Ⅵ型9例；X射线平片漏 诊8例，其骨折准确率89.3%，MSCT准确 率为100%，采用MSCT检查后纠正分型12 例；与CPR、VR、SSD、MIP比较，任意面 重建(MPR)的和特异度(93.6%)、灵敏度 (88.5%)、阳性预测值(96.5%)和阴性预测 值(78.6%)均较高，差异有统计学意义(P ＜0.05)，MSCT结果与手术病理显示率比 较，差异无统计学意义(P＞0.05)。结论 采用多层螺旋CT检查膝关节外伤，可提供 更准确、清晰的影像信息，对明确临床诊 断及治疗具有良好的指导意义。

Objective To explore the value of Multi Slice Helical CT(MSCT) in primary knee injury. Methods Sixty cases of suspected knee joint fractures were collected from January 2016 to September2018 in our hospital. After MSCT examination, post-treatment reconstruction was used to adjust the appropriate window width and window level to limit the fractures of the knee joint (including the tiny Fractures), ligament injury, meniscus injury, joint effusion or hemorrhage, soft tissue contusion and so on, the type of knee joint fracture was compared with the surgical pathological results to calculate the diagnostic accuracy, sensitivity, positive predictive value, negative Predictive value. Results Among the 60 cases of knee trauma, there were 10 cases of type Ⅰ, 12 cases of type Ⅱ, 16 cases of type Ⅲ, 5 cases of type Ⅳ, 8 cases of type Ⅴ and 9 cases of type Ⅵ. There were 8 cases of missed diagnosis of X-ray, The accuracy of MSCT was 89.3%, the accuracy of MSCT was 100%, and 12 cases were corrected by MSCT. The sensitivity and specificity of MPR were 88.5% and 93.6% respectively, the positive predictive value was 96.5% and the negative predictive value was 78.6%, which was higher than that of CPR,VR,SSD and MIP (P <0.05). There was no significant difference between MSCT and surgical pathology (P> 0.05). Conclusion Multi-slice spiral CT examination of knee injury, can provide more accurate and clear image information, the clear clinical diagnosis and treatment has a good guiding significance.