摘要
目的分析、评价x线、MSCT、MRI对胫骨下1／3螺旋骨折合并后踝隐匿性骨折的诊断价值。方法对151例胫骨下1／3螺旋骨折进行了X线检查，未发现后踝骨折的患者行MSCT及MR检查。MSCT与MRI对于后踝骨小梁骨折和骨皮质骨折的显示能力比较采用二项分布检验。结果151例胫骨下1／3螺旋骨折患者中有126例（83．4％）发现合并后踝骨折，其中x线检出27例（21．4％）。124例行MSCT和MR检查，MRI检出后踝隐匿性骨折有99例，其中MSCT检出8l例。MRI诊断后踝隐匿性骨折的敏感度、特异度、准确度分别为100％（99／99）、100％（25／25）、100％（124／124），MSCT分别为81．8％（81／99）、100％（25／25）、85．5％（106／124）。MRI对后踝隐匿性骨折的诊断准确度高于MSCT（Z=2．56，P=0．01）。MSCT和MRI检出的99例后踝隐匿性骨折中，MSCT检出骨折累及骨皮质78例，MRI检出5l例，MSCT诊断后踝隐匿性骨折累及骨皮质的敏感度、特异度、准确度分别为100％（78／78）、100％（21／21）、100％（99／99），MRl分别为65．4％（51／78）、100％（21／21）、72．7％（72／99），MSCT对后踝隐匿性骨折累及骨皮质的诊断准确度高于MRI（Z=4．02，P=0．00）。结论MRI对胫骨下1／3螺旋骨折合并后踝隐匿性骨折的诊断准确度高于MSCT，MSCT对后踝隐匿性骨折累及骨皮质的诊断准确度高于MRI。
Objective To analyze the diagnostic value of MSCT and MRI in detecting the distal third of tibia shaft fracture complicated with occult posterior malleolar fracture. Methods One hundred and fifty-one patients with the distal third of tibia shaft spiral fracture underwent X-ray examination. For patients without posterior malleolar fracture on X-ray, MSCT and MR imaging were further performed. A binomial test was used to evaluate the significance of the differences between MSCT and MRI in the detection of posterior malleolar fractures and cortical involvement. Results A total of 126 （83.4%） in 151 tibia shaft fracture were found to be associated with posterior malleolar fracture. Twenty-seven （21.4%） cases with posterior malleolar fracture were detected on X-ray. MSCT and MR examination were performed in 124 cases. Ninety-nine posterior malleolar occult fractures were detected on MRI, which included 81 cases showed on MSCT. The sensitivity, specificity and accuracy of posterior malleolar occult fracture on MRI were 100% （99/99）, 100% （25/25） and 100% （ 124/124）, while they were 81.8% （ 81/99）, 100% （25/25） and 85.5% （106/124） for MSCT respectively. The accuracy of posterior malleolar occult fracture on MRI was significant higher than MSCT （ Z = 2. 56, P = 0. 01 ）. Seventy-eight cortical fractures were found on MSCT among 99 posterior malleolar occult fractures, while 51 fractures were found on MRI. The sensitivity, specificity and accuracy of cortical fracture involvement were 100% （78/78）, 100% （21/21）and 100% （99/ 99） for MSCT, while they were 65.4% （51/78）, 100% （21/21） and 72. 7% （72/99）for MRI respectively. The accuracy of cortical fracture involvement on MSCT was significant higher than MRI （ Z = 4. 02, P =0. 00）. Conclusions MRI has a higher accuracy than MSCT in detecting the distal third of tibia shaft fracture complicated with occult posterior malleolar fracture, while MSCT has a higher accuracy than MR! in detecting cortical fracture involve
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第6期544-547,共4页
Chinese Journal of Radiology
关键词
胫骨骨折
踝
骨折
闭合性
诊断显像
Tibial fractures
Ankle
Fractures,closed
Diagnostic imaging
