64排螺旋CT多平面重建及容积再现技术在复杂胫骨平台骨折诊断中的应用

孙大永; 马小开; 陈刘成; 刘浩; 杨波; 郭俊宁

doi:10.16766/j.cnki.issn.1674-4152.002554

64排螺旋CT多平面重建及容积再现技术在复杂胫骨平台骨折诊断中的应用

doi: 10.16766/j.cnki.issn.1674-4152.002554

1.
蚌埠市第三人民医院CT室，安徽蚌埠 233000
2.
蚌埠医学院第一附属医院甲乳外科，安徽蚌埠 233004
3.
蚌埠医学院第一附属医院放射科，安徽蚌埠 233004
4.
怀远县人民医院CT室，安徽蚌埠 233400

基金项目:

安徽省高校自然科学研究项目 KJ2019A0347

详细信息

通讯作者:
孙大永, E-mail: luxmiao@sina.com

中图分类号: R814.42 R683.42
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- 被引次数: 0
出版历程
- 收稿日期: 2021-09-25
- 网络出版日期: 2022-09-23

Application of 64-slice spiral CT multiplanar reconstruction and volume rendering technique in complex tibial plateau fractures

1.
Department of Radiology, the Third People's Hospital of Bengbu, Bengbu, Anhui 233000, China

摘要

摘要: 目的研究和探索64排螺旋CT多平面重建及容积再现技术在胫骨平台骨折诊断、分型以及制定方案时的价值和作用。方法对蚌埠市第三人民医院2020年6月—2021年12月收治的69例疑似胫骨平台骨折患者资料进行收集整理，通过CT扫描的方式获得胫骨骨折的相关数据信息，然后借助ADW4.4工作站对数据进行多平面重建和容积再现，以此来诊断患者的病情。相对于X线片，分析研究诊断符合率以及分型正确率情况。结果共计确诊胫骨平台骨折患者65例，其中男性35例，女性30例。平均年龄为(48.98±15.68)岁。本研究人群50~59岁年龄段患者所占比例最高(26.2%)。其次为40~49岁年龄段，占比为23.1%。Schatzker Ⅰ型胫骨平台骨折为高发类型，共19例，占骨折总数的29.2%，Schatzker Ⅱ型次之，占比26.2%，其次为Schatzker Ⅲ型和Schatzker Ⅳ型，均占13.8%。不同性别Schatzker分型情况差异无统计学意义(P＞0.05)。与手术分型标准相比，X线诊断结果的准确率为81.5%(53/65)，CT MPR+VR诊断结果准确率为98.5%(64/65)，差异有统计学意义(χ²=10.342，P＜0.01)。结论通过64排螺旋CT进行多平面重建和容积再现，能很好地识别和诊断出患者胫骨骨折的真实情况，还能深度发掘患者关节周隐匿性损害，为临床治疗提供有力的依据。
- 64层螺旋CT /
- 多平面重建体层摄影术 /
- 胫骨平台骨折 /
- Schatzker分型系统
Abstract: Objective To investigate the value of 64-slice spiral CT multiplanar reconstruction (MPR) and volume rendering (VR) technique in the diagnosis, classification and treatment plan of tibial plateau fractures. Methods The clinical data of 69 suspected patients with tibial plateau fracture in the Third people's Hospital of Bengbu from June 2020 to December 2021 were selected. The relevant data of tibial fracture were obtained by CT scanning, and the data were reconstructed and volume reconstructed by ADW4.4 workstation to diagnose the patient's condition. Compared with diagnostic of X-ray, the diagnostic coincidence rate and typing accuracy were analyzed and studied. Results A total of 65 patients with tibial plateau fractures were diagnosed, including 35 males and 30 females, the average age was (49.69±15.91) years. In this study, patients aged 50-59 years accounted for the highest proportion (26.2%), followed with patients aged 40-49 years (23.1%). Schatzker type Ⅰ tibial plateau fracture was the most common type, with 19 cases (29.2%), followed by Schatzker type Ⅱ(26.2%), Schatzker type Ⅲ(13.8%) and Schatzker type Ⅳ(13.8%). There was no significant difference in Schatzker classification between Sexes (P > 0.05). Compared with the standard of surgical classification, the accuracy of X-ray diagnosis was 81.5% (53/65), and the accuracy of CT MPR+VR was 98.5% (64/65), with statistically significant difference (χ² =10.342, P < 0.01). Conclusion 64-slice spiral CT multiplanar reconstruction and volume reconstruction technology can well identify and diagnose the true situation of tibial fracture, and deeply explore the hidden damage around the joint, which can provide a powerful basis for clinical treatment.
- 64-slice spiral CT /
- MPR tomography /
- Tibial plateau fracture /
- Schatzker classification

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表 1 X线片与64排螺旋CT多平面重建检查的诊断效能比较(%)

Table 1. Comparison ofdiagnostic efficacy of X-ray and 64-row spiral CT MPR+VR (%)

检查方法	灵敏度	特异度	准确度
X线片	81.5(53/65)	25.0(1/4)	78.3(54/69)
64排螺旋CT多平面重建	98.5(64/65)	50.0(2/4)	95.7(66/69)
χ²值	9.091	＜0.001	0.091
P值	0.003	0.999	0.003

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表 2 不同检查方法诊断胫骨平台骨折分型结果[例(%)]

Table 2. Classification results of tibial plateau fracture were diagnosed by different examination methods [cases (%)]

骨折分型	手术分型	X线诊断结果	CT MPR+VR诊断结果
Ⅰ型	19	14(73.7)	18(94.7)
Ⅱ型	17	13(76.5)	17(100.0)
Ⅲ型	9	8(88.9)	9(100.0)
Ⅳ型	9	8(88.9)	9(100.0)
Ⅴ型	7	6(85.7)	7(100.0)
Ⅵ型	4	4(100.0)	4(100.0)
合计	65	53(81.5)	64(98.5)
注：不同检查方法诊断结果合计比较，χ²=10.342，P=0.001。

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表 3 不同性别各年龄段患者胫骨平台骨折情况比较[例(%)]

Table 3. Comparison of tibial plateau fractures in patients of different gender and all ages [cases (%)]

年龄段(岁)	男性	女性	合计
12~29	5(14.3)	3(10.0)	8(12.3)
30~39	5(14.3)	2(6.7)	7(10.8)
40~49	8(22.9)	7(23.3)	15(23.1)
50~59	7(20.0)	10(33.3)	17(26.2)
60~69	9(25.7)	5(16.7)	14(21.5)
＞70	1(2.9)	3(10.0)	4(6.2)
合计	35(100.0)	30(100.0)	65(100.0)
注：不同性别各年龄段胫骨平台骨折情况比较，Z=-0.566, P=0.571。

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表 4 不同性别Schatzker分型情况比较[例(%)]

Table 4. Comparison of Schatzker typing by different sex [cases (%)]

Schatzker分型	男性	女性	合计
Ⅰ型	9(25.7)	10(33.3)	19(29.2)
Ⅱ型	10(28.6)	7(23.3)	17(26.2)
Ⅲ型	5(14.3)	4(13.3)	9(13.8)
Ⅳ型	6(17.1)	3(10.0)	9(13.8)
Ⅴ型	3(8.6)	4(13.3)	7(10.8)
Ⅵ型	2(5.7)	2(6.7)	4(6.2)
合计	35(100.0)	30(100.0)	65(100.0)
注：不同性别Schatzker分型情况比较，χ²=1.460，P=0.918。

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