多层螺旋CT多层面重组定量评价Colles骨折的可行性研究

发布时间：2018-01-13 00:02

本文关键词：多层螺旋CT多层面重组定量评价Colles骨折的可行性研究　出处：《中国骨伤》2016年01期 　论文类型：期刊论文

【摘要】：目的 :探讨多层螺旋CT(MSCT)多层面重组图像(MPR)定量评价Colles骨折的可行性和可靠性。方法 :自2011年6月至2014年6月,选取拍摄腕关节正侧位X线片并行MSCT扫描的Colles骨折患者36例,男11例,女25例;年龄35~72岁,平均(42.5±5.4)岁。均在外伤后2 d内进行X线片和CT检查,检查图像均通过PACS局域网传送至工作站,根据X线正侧位片及MSCT-MPR图像分别进行远骨折块背侧嵌插深度、掌倾角和腕关节面塌陷错位度进行测量,间隔2周后再重复测量1次。比较前后2次测量结果及其相关性。结果:36例患者中X线和MPR均能测量掌倾角,嵌插深度21例及关节面塌陷错位16例;伤后2 d的X线片测得掌倾角、嵌插深度和关节面塌陷度分别为(12.5±3.6)°、(4.5±2.1)mm、(3.7±1.6)mm,2周后分别为(4.8±2.2)°、(6.4±3.6)mm、(2.5±1.2)mm;前后比较各参数差异有统计学意义,中低度相关(r=0.681、0.640、0.345)。MPR图像伤后2 d测量分别是(14.5±5.3)°、(4.2±1.2)mmm、(5.7±2.3)mm,2周后分别为(13.2±2.6)°、(4.7±2.2)mm、(4.6±2.1)mm;前后比较,关节面塌陷度有差异,其余差异无统计学意义(P0.05),具有中度以上相关性(r=0.954、0.854、0.642)。X线片测量的掌倾角、嵌插深度和关节面塌陷度与MPR比较,差异有统计学意义(P0.05),具有低或中度相关性(r=0.454、0.532、0.378)。结论:借助MSCT的MPR图像,可对Colles骨折进行多个参数测量,作出定量评价,且重复测量可靠性更好。
[Abstract]:Objective: to investigate the MPRs of multilayer spiral CTT (MSCT) with multi-slice reconstruction. The feasibility and reliability of Colles fracture were evaluated quantitatively. Methods: from June 2011 to June 2014. Thirty-six patients (11 males and 25 females) with Colles fracture were selected to take radiographs of the wrist joint on anteroposterior and lateral radiographs and MSCT scanning. The age was 35 ~ 72 years (mean 42.5 卤5.4) years. X-ray and CT examinations were performed within 2 days after trauma. The images were transmitted to the workstation via PACS LAN. The depth of dorsal insertion, the angle of palmar inclination and the degree of dislocation of wrist joint were measured according to X-ray and MSCT-MPR images. Results X-ray and MPR could measure palmar inclination angle in 36 cases. The depth of insertion was 21 cases and the dislocation of articular surface was 16 cases. On the 2nd day after injury, the angle of palmar inclination, the depth of insertion and the degree of collapse of articular surface were 4.5 卤2.1 mm and 3.7 卤1.6 mm, respectively. After 2 weeks, it was 4. 8 卤2. 2 掳and 6. 4 卤3. 6 卤3. 6 卤2. 5 卤1. 2 mm respectively. The difference of the parameters before and after injury was statistically significant. The mean correlation was 0.681U 0.6400.345.MPR images were measured at 14.5 卤5.3 掳2 days after injury. After 2 weeks, the values of 4.2 卤1.2 卤1.2 卤2.3 卤2.3 mm / m were 13.2 卤2.6 掳and 4.7 卤2.2 mm / d respectively, and were 4.6 卤2.1 mm / d respectively. The degree of collapse of articular surface was different before and after, the other differences were not statistically significant (P 0.05), and had a moderate correlation (r = 0.954 ~ 0.854). Compared with MPR, the angle of palmar inclination, the depth of insertion and the degree of articular surface collapse measured by 0.642X ray film were significantly different from those of MPR (P 0.05), and had a low or moderate correlation (P < 0.05). Conclusion: with the help of MPR images of MSCT, multiple parameters of Colles fracture can be measured and evaluated quantitatively, and the reliability of repeated measurement is better.
【作者单位】：温州医科大学附属第二医院放射科;温州市瓯海区第三人民医院放射科;
【基金】：温州市科技局科技项目(编号:Y20130218) 温州市瓯海区科技发展计划项目(编号:20143001)~~
【分类号】：R816.8;R687.3
【正文快照】： Colles骨折是临床常见骨折,多见于中老年妇女,大多采取保守治疗,少部分行手术治疗,临床医师常关注骨折断端的移位、成角、嵌插及关节面塌陷程度等,这涉及到精准治疗时手法运用,治愈后功能恢复的判断等[1-3]。过去这些参数基本通过X线片进行观察和测量,但其检查的局限性影响到

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