MSCT对老年桡骨远端骨折诊断分型的应用价值

doi:10.12117/jccmi.2019.02.015

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摘要目的：探讨多层螺旋CT（MSCT）图像重建在老年桡骨远端骨折患者分型中的诊断应用价值。方法：回顾性选择96例老年桡骨远端骨折患者，其中男34例，女62例，年龄60～86岁，平均（67.4±7.6）岁。治疗前均拍摄患侧腕关节正侧位X线片，并进行MSCT检查。根据AO/ASIF分型，分别对X线正侧位片及CT原始图像和重建图像进行桡骨远端骨折诊断分型。结果：96例患者经X线平片检查，漏诊8例，88例诊断骨折；包括A型45例（46.88%）、B型9例（9.38%）、C型34例（35.42%）。经MSCT扫描及重建图像的96例患者均发现桡骨远端骨折，包括A型11例（11.45%），B型10例（10.42%），C型75例（78.13%）。两种检查方式对桡骨远端骨折分型的差异有统计学意义（χ2=35.02，P＜0.01），且一致性程度弱（Kappa=0.242，P＜0.01）。结论：MSCT扫描及重建图像对老年桡骨远端骨折诊断及分型更准确全面，尤其对复杂关节内骨折的评价具有重要临床价值。

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	姜宏宁1
	沈文婷2

关键词 ：桡骨骨折, 体层摄影术, 螺旋计算机, 放射摄影术

Abstract：Objective: To investigate the application value of MSCT in the classification of distal radius fracture in elder patients after comparison with X-ray. Methods: Ninety-six elderly patients with distal radius fractures were retrospectively enrolled with 34 males and 62 females, aged from 60 to 86 years((67.4±7.6) years in average). All cases performed X-ray and CT examination before any therapy. Detection results of different types of fractures were compared between the X-ray and MSCT scans and its image reconstruction, referring to the classification of AO/ASIF(Arbeitsgemeinschaft für Osteosynthesefragen/Association for the Study of Internal Fixation). Results: Among the 96 cases, 88 cases(91.67%) were diagnosed as fractures by X-ray and 8 cases were misdiagnosed. Patients with type A, B and C fractures were 45 cases(46.88%), 9 cases(9.38%) and 34 cases(35.42%) respectively. Ninety-six cases with fractures were diagnosed by MSCT and patients with type A, B and C fractures were 11 cases(11.45%), 10 cases(10.42%) and 75 cases(78.13%) respectively. There were statistical difference between the two technologies in evaluating the classification of distal radius fracture(χ2=35.02, P＜0.01), with less consistency(Kappa=0.242, P＜0.01). Conclusion: MSCT is more detailed and accurate for differential diagnosis and classification of elderly distal radius fractures, especially for complex intra-articular fracture, compared with conventional X-ray.

Key words： Radius fractures Tomography, spiral computed Radiography

收稿日期: 2018-03-15

PACS:	Ｒ683.41
	Ｒ814.42
	Ｒ814.41

通讯作者: 沈文婷，杨浦区中医医院放射科，200090。E-mail：graceswt@126.com

作者简介: 姜宏宁（1963-），女，上海人，主任医师。E-mail：jianghn2009@sina.com

引用本文:

姜宏宁1，沈文婷2. MSCT对老年桡骨远端骨折诊断分型的应用价值[J]. 中国临床医学影像杂志, 2019, 30(2): 135-138.
JIANG Hong-ning1, SHEN Wen-ting2. The application value of MSCT in classifying distal radius fracture in elderly patients. JOURNAL OF CHINA MEDICAL IMAGING, 2019, 30(2): 135-138.

链接本文:

http://www.jccmi.com.cn/CN/10.12117/jccmi.2019.02.015 或 http://www.jccmi.com.cn/CN/Y2019/V30/I2/135

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