摘要
目的观察多层螺旋CT(MSCT)扫描三维重建检查与MRI检查对于不同特征下颌骨髁突骨折的鉴别诊断效果。方法以自2019年6月—2021年6月于衢州市中医医院及浙江大学医学院附属第二医院就诊并接受手术治疗的150例下颌骨髁突骨折患者为研究对象,分别于术前对全部患者进行MSCT扫描三维重建检查与MRI检查,统计2种检查方法对下颌骨髁突骨折类型和骨折移位情况的诊断灵敏度、特异性和准确度,以及对于软组织损伤情况的诊断符合性。结果MSCT扫描三维重建检查与MRI检查对于髁头骨折、髁突颈部骨折和髁突下骨折等不同下颌骨髁突骨折类型的诊断灵敏度、特异性和准确度差异均无统计学意义(均P>0.05)。MSCT扫描三维重建检查与MRI检查对于原位骨裂、弯曲移位和错动移位骨折等不同下颌骨髁突骨折移位情况的诊断灵敏度、特异性和准确度差异均无统计学意义(均P>0.05)。MRI检查对于韧带撕裂和髁突表面软骨损伤的诊断符合性[81.97%(50/61)和80.49%(66/82)]均显著高于MSCT扫描三维重建检查水平[63.93%(39/61)和65.85%(54/82)],χ^(2)=5.587、4.473;P=0.018、0.034。结论MSCT扫描三维重建检查对于下颌骨髁突骨折类型和移位情况的诊断能力可与MRI检查媲美,而MRI对于软组织损伤诊断能力更优,临床可通过2种方法联合应用,以提高下颌骨髁突骨折及周围软组织损伤的综合诊断效能。
Objective To observe the differential diagnosis effect of MSCT three-dimensional reconstruction and MRI on mandibular condylar fracture with different characteristics.Methods A total of 150 patients with mandibular condylar fracture treated at Quzhou Hospital of Traditional Chinese Medicine and the Second Affiliated Hospital of Zhejiang University School of Medicine from June 2019 to June 2021 were studied.All patients underwent multi-slice spiral CT(MSCT)scanning,three-dimensional reconstruction and MRI before operation.The sensitivity,specificity and accuracy of the two methods in the diagnosis of mandibular condylar fracture types and fracture displacement,as well as the diagnostic coincidence of soft tissue injury,were investigated.Results There was no significant difference in the sensitivity,specificity and accuracy of MSCT three-dimensional reconstruction and MRI in the diagnosis of different types of mandibular condylar fractures,such as condylar head fracture,condylar neck fracture and subcondylar fracture(all P>0.05).There was no significant difference in the sensitivity,specificity and accuracy of MSCT three-dimensional reconstruction and MRI in the diagnosis of different mandibular condylar fracture displacement,such as in situ bone fracture,bending displacement and dislocation fracture(all P>0.05).The diagnostic accuracy of MRI for ligament tear and condylar surface cartilage injury[81.97%(50/61)and 80.49%(66/82)]was significantly higher than that of MSCT scanning three-dimensional reconstruction[63.93%(39/61)and 65.85%(54/82)],χ^(2)=5.587,4.473;P=0.018,0.034.Conclusion The diagnostic ability of MSCT scanning three-dimensional reconstruction for the type and displacement of mandibular condylar fracture is comparable to that of MRI,whereas MRI has better diagnostic ability for soft tissue injury.Clinically,the two methods can be combined to improve the comprehensive diagnostic efficiency of mandibular condylar fracture and surrounding soft tissue injury.
作者
黄洪
徐旭
严钦
方欣
HUANG Hong;XU Xu;YAN Qin;FANG Xin(Department of Radiology,Quzhou Hospital of Traditional Chinese Medicine,Quzhou,Zhejiang 324002,China;不详)
出处
《中华全科医学》
2022年第3期461-463,510,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2018KY878)。
关键词
多层螺旋CT扫描
三维重建
核磁共振
下颌骨髁突骨折
软组织损伤
诊断效能
Multi-slice spiral CT scanning
Three-dimensional reconstruction
Nuclear magnetic resonance
Mandibular condylar fracture
Soft tissue injury
Diagnostic efficiency
