CT扫描对桡骨远端B3骨折的诊断价值

发布时间：2018-04-26 04:28

本文选题：桡骨骨折 + 诊断　；参考：《北京大学学报(医学版)》2017年04期

【摘要】：目的:评价三维CT扫描是否提高对AO分型B3型桡骨远端骨折的检出率。方法:选择2013年1月至2014年1月,北京积水潭医院创伤骨科急诊收治的30例桡骨远端骨折患者进行回顾性分析,所有患者均接受了切开复位内固定术,采集所有病例的原始X线片和三维CT扫描图像,由2名医师先根据X线片作出骨折的AO分型诊断,再根据三维CT扫描检查结果作出骨折AO分型诊断,将X线与三维CT扫描作出的诊断结果进行比较,评价X线和CT对B3骨折的检出率,并计算Cohen’s Kappa值判断X线片和CT对B3型骨折的诊断是否一致。结果:30例骨折病例经手术确认均为B3型桡骨远端骨折,10例术中确认为B3.3型骨折。三维CT检查结果的诊断与手术判断一致,而单纯依靠X线片只能诊断24例(24/30,80%)的B3型骨折,发现6例(6/10,60%)B3.3型骨折。CT扫描对B3型骨折的检出率优于X线(100%vs.80%,P0.05),对B3.3型骨折的检出率也优于X线(100%vs.60%,P0.05)。CT扫描和X线检查对B3和B3.3型骨折诊断的一致性较差(kappa值=0),最重要的是在此研究过程中发现并描述了两种特殊类型的B3型骨折,即桡侧B3型骨折和尺侧B3型骨折。结论:CT可以显著提高B3和B3.3桡骨远端骨折的诊断率,并有助于我们发现两种特殊类型的B3型骨折。
[Abstract]:Objective: to evaluate whether three-dimensional CT scan can improve the detection rate of type B 3 distal radius fracture. Methods: from January 2013 to January 2014, 30 patients with distal radius fractures treated in emergency department of trauma and orthopedics, Beijing Jishuitan Hospital, were retrospectively analyzed. All patients were treated with open reduction and internal fixation. The original X-ray and 3D CT images of all cases were collected. The AO classification of fracture was diagnosed by two physicians according to X-ray film, and then AO classification was made according to the results of 3D CT scan. The diagnostic results of X-ray and 3D CT scanning were compared to evaluate the detection rate of B3 fracture by X-ray and CT, and the Cohen's Kappa value was calculated to determine whether the diagnosis of B3 fracture was consistent with that of X-ray film and CT. Results all the 30 cases were confirmed as type B3 distal radius fractures. 10 cases were confirmed as type B3.3 fractures during operation. The diagnosis of 3D CT was consistent with the surgical diagnosis, but only 24 cases of B3 fracture with 24 / 30 / 80) could be diagnosed by X-ray alone. It was found that the detectable rate of B3 fracture in 6 cases of B3.3 fracture was better than that of X ray 100 vs.80 and P0.05, and the detection rate of B3.3 fracture was also superior to that of X ray 100 vs.60 + P 0.05. Ct scan and X ray examination in the diagnosis of B3 and B3.3 fractures. The most important is that the diagnosis of B3 and B3.3 fractures has a poor consistency. The most important thing is that the diagnostic accuracy of B3 and B3.3 fractures is lower than that of X ray scan and X ray examination in the diagnosis of B3 and B3.3 fractures. During this study, two special types of B3 fractures were found and described. Radial B 3 fracture and ulnar B 3 fracture. ConclusionThe diagnostic rate of B3 and B3.3 distal radius fractures can be significantly improved by the use of VCT, and it is helpful for us to find two special types of B3 fractures.
【作者单位】：北京积水潭医院创伤骨科;
【基金】：北京市卫生系统高层次卫生技术人才培养计划项目(2013-3-031)资助~~
【分类号】：R683;R816.8

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