非典型脂肪-血液界面征用于膝关节隐匿性骨折X线诊断价值

发布时间：2018-02-24 00:45

本文关键词： 膝关节隐匿性骨折脂肪-血液界面征积脂血症 X线平片诊断　出处：《临床放射学杂志》2015年03期 　论文类型：期刊论文

【摘要】：目的探讨非典型脂肪-血液界面(FBI)征在膝关节隐匿性骨折X线诊断中的价值。方法回顾性分析99例膝关节外伤后X线检查阴性,经CT检查确诊膝关节隐匿性骨折和排除膝关节骨折患者的常规膝关节X线及CT资料。CT检查作为金标准,所有的检查均在3天内完成。结合CT描述积脂血症在X线侧位髌上囊的影像表现,作为非典型FBI征。统计隐匿性骨折和无骨折两组资料X线平片显示非典型FBI征的情况,并统计分析以X线侧位髌上囊非典型FBI征作为标准判定膝关节隐匿性骨折的准确度、灵敏度、特异度、阳性似然比、阴性似然比、阳性预测值、阴性预测值。结果 99例患者中,CT确诊隐匿性骨折57例,均存在不同程度的积脂血症,CT检查典型的FBI征见于13例(22.8%)隐匿性膝关节骨折病例,表现为液-液平面10例(17.5%),有时还可以出现三层3例(5.3%)。或者仅表现为关节积血、积液44例(77.2%)。其中51例于X线侧位髌上囊见密度增高,表现为卵圆形、长圆形、条样或斑片样等形态,可以作为FBI征的非典型表现。CT确诊膝关节隐匿性骨折者的X线非典型FBI征发生率为89.5%,明显高于CT排除膝关节骨折者的X线非典型FBI征发生率11.9%,(χ2=56.106,P0.05)。由X线侧位髌上囊密度增高,即不典型FBI征提示膝关节隐匿性骨折的准确度88.9%,灵敏度89.5%,特异度88.1%,阳性似然比7.52,阴性似然比0.12,阳性预测值91.1%,阴性预测值86.1%。结论外伤后膝关节X线侧位髌上囊密度增高可以作为FBI征的非典型表现,对膝关节隐匿性骨折具有较高的提示作用,可作为诊断膝关节隐匿性骨折的间接征象。
[Abstract]:Objective to investigate the atypical fat blood interface (FBI) syndrome in X-ray diagnostic value of occult fracture of knee joint. Methods: a retrospective analysis of 99 cases of knee joint trauma after negative X-ray examination, diagnosed by CT occult fracture of knee joint and knee joint fracture patients excluded routine knee joint X line and check the CT data as.CT the gold standard, complete all the checks within 3 days. Imaging findings combined with CT description lipohemarthrosis in X-ray lateral suprapatellar bursa, as atypical FBI syndrome. Two groups of data of fracture X-ray showed atypical FBI syndrome without statistical and occult fracture, and statistical analysis with atypical FBI syndrome X capsule as a standard to determine the lateral patellar occult fracture of knee joint accuracy, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio, positive predictive value, negative predictive value. Results of the 99 patients, 57 cases of CT confirmed the diagnosis of occult fracture, there were not The same degree of lipohemarthrosis, CT typical FBI syndrome was found in 13 cases (22.8%) cases of occult fracture of the knee, 10 cases were diagnosed as liquid-liquid plane (17.5%), sometimes also can appear three layers in 3 cases (5.3%). Or only showed hemarthrosis, effusion in 44 cases (77.2%) in 51 cases in lateral X-ray of suprapatellar bursa see increased density is oval, oblong, spline or patchy form, can be used as FBI syndrome atypical.CT diagnosis of occult fracture of knee joint by X-ray atypical FBI syndrome incidence rate was 89.5%, significantly higher than that of CT out of the knee joint fracture the incidence of atypical FBI syndrome X 11.9%, (x 2=56.106, P0.05). Increased by lateral X-ray of suprapatellar bursa density is not typical accuracy of 88.9%, suggesting that FBI syndrome of occult fracture of knee joint sensitivity 89.5%, specificity 88.1%, positive likelihood ratio 7.52, negative likelihood ratio was 0.12, the positive predictive value of 91.1%, negative the predictive value of 86.1%.. The increase of X-ray lateral patellar pouch density after trauma can serve as an atypical manifestation of FBI sign. It has a suggestive effect on occult fracture of the knee and can be used as an indirect sign for the diagnosis of occult fracture of the knee joint.

【作者单位】：复旦大学附属华山医院宝山分院放射科;复旦大学附属华山医院放射科;
【分类号】：R684;R816.8

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