摘要
目的探析多层螺旋CT(MSCT)对膝关节损伤后胫骨平台隐匿性骨折早期检出及对Schatzker分型的准确性。方法回顾性分析2015年1月—2017年6月陕西省核工业二一五医院骨科收治的膝关节损伤后高度怀疑胫骨平台隐匿性骨折85例,以手术结果为金标准,分析MSCT对胫骨平台隐匿性骨折诊断效能、Schatzker分型的准确性。结果 MSCT对胫骨平台隐匿性骨折早期诊断灵敏度为98.75%,特异度为60.00%,准确率为96.47%,漏诊率为1.18%,误诊率为2.35%,MSCT对无骨折及I型、II型、III型、IV型、V型、VI型准确率分别为60.00%、87.50%、92.86%、100.00%、100.00%、93.55%、100.00%,总体诊断准确率为92.94%,误诊率为7.06%。结论 MSCT重建可得到薄层图像、多层面重建及容积再现图像,多平面、多角度显示细微病变,明显提高膝关节损伤后胫骨平台隐匿性骨折的检出率,全面评估创伤的程度和范围,准确分型并指导临床手术方案。
Objective To investigate early diagnosis rate in patients with tibial plateau occult fracture after inju- ry of knee joint and the accuracy of Schatzker typing by lnuhislice CT （MSCT）. Methods Clinical data of 85 injury of knee joint patients who were highly suspected as having tibial plateau occult fracture during January 2015 and June 2017 was retrospectively analyzed. Operative result was used as gold standard to analyze diagnostic efficacy of tibial plateau oc- cult fracture and accuracy of Schatzker classification by MSCT. Results Sensitivity, specificity, accuracy rate, rate of missed diagnosis and lnisdiagnosis rate of MSCT in early diagnosis of tibial plateau occult fracture were 98. 75% , 60. 00% , 96.47% , 1.18% and 2.35% respectively. Accuracy rates of MSCT in diagnosis of non fractures, Schatzker type I, type II, type Ⅲ, type Ⅳ, type V and type Ⅵ were 60.00% , 87.50% , 92.86% , 100.00% , 100.00% , 93.55% and 100.00% respectively, and the overall diagnostic accuracy rate was 92.94% , and lnisdiagnosis rate was 7.06%. Conclusion MSCT reconstruction may get lalnellar images, lnultiplanar reconstruction and vaulme rendering images, lnultiplanar and lnuhi-angle display of minim lesions, and it may significantly improve detection rate of e tibial plateau oeeuh fracture after injm7 of knee joint, and eolnprehensively assess degree and extent of trauma, accurately clas- sify and guide clinical operation plan.
作者
张军胜
赵波
ZHANG Jun-sheng;ZHAO Bo(Department of Radiology,Nuclear industry 215 Hospital of Shanxi Province,Xian-yang,Shaanxi 712000,China;Department of Orthopaedics,the Second Affiliated Hospital of Xihn Jiaotong Universi-ty,Xihn 710000,China)
出处
《解放军医药杂志》
CAS
2018年第8期96-99,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省社会发展科技攻关项目(20155F012)
