螺旋CT影像特征在踝關節骨折患者骨折分型及療效評估中的應用價值

黃劍勇 陸火麗 王浩亞

【摘要】 目的：探討螺旋CT影像特征在踝關節骨折患者骨折分型及療效評估中的應用價值。方法：收集2017年10月-2019年10月筆者所在醫院收治的356例踝關節骨折患者作為研究對象，所有患者手術前后均行CT和X線片檢查，并行術前骨折分型，以術中探查結果作為診斷金標準，觀察CT檢查影像特征在術前骨折分型及手術療效評估中的應用價值。結果：螺旋CT對踝關節骨折分型診斷準確率為98.03%，X線片對踝關節骨折分型診斷準確率為89.61%，螺旋CT對踝關節骨折分型診斷準確率高于X線片，差異有統計學意義（P<0.05）。螺旋CT對踝關節骨折術后解剖復位檢出率為92.13%，對踝關節骨折內固定置入適宜檢出率為93.26%;X線片對踝關節骨折術后解剖復位檢出率為82.58%，對踝關節骨折內固定置入適宜檢出率為81.46%;螺旋CT對踝關節骨折術后解剖復位和內固定置入適宜檢出率均高于X線片，差異均有統計學意義（P<0.05）。結論：螺旋CT對踝關節骨折分型及術后復位、內固定置入質量評估的準確率較高，具有較高的診斷和療效評估價值，可為踝關節骨折患者的診治提供診斷依據。

【關鍵詞】 螺旋CT 影像特征 踝關節骨折 骨折分型 療效評估

doi：10.14033/j.cnki.cfmr.2020.16.025 文獻標識碼 B 文章編號 1674-6805（2020）16-00-03

Application Value of Spiral CT Image Features in Fracture Classification and Efficacy Evaluation of Patients with Ankle Fracture/HUANG Jianyong， LU Huoli， WANG Haoya. //Chinese and Foreign Medical Research， 2020， 18（16）： -65

[Abstract] Objective： To explore the application value of spiral CT image features in fracture classification and efficacy evaluation of patients with ankle fracture. Method： A total of 356 patients with ankle fracture admitted to the authors hospital from October 2017 to October 2019 were collected as research objects. All patients underwent CT and X-ray examination before and after surgery， and preoperative fracture classification was conducted. Intraoperative exploration results were used as the gold standard for diagnosis. the application value of CT imaging features in preoperative fracture classification and surgical efficacy evaluation were observed. Result： The diagnostic accuracy of spiral CT in the classification of ankle fracture was 98.03%， and that of X-ray in the classification of ankle fracture was 89.61%. The diagnostic accuracy of spiral CT in the classification of ankle fracture was higher than that of X-ray， and the difference was statistically significant （P<0.05）. The detection rate of anatomic reduction by spiral CT was 92.13%， and the internal fixation of ankle fracture by spiral CT was 93.26%. The detection rate of anatomic reduction by X-ray was 82.58%， and the internal fixation of ankle fracture by X-ray was 81.46%. The appropriate detection rate of spiral CT for anatomic reduction and internal fixation of ankle joint fracture were higher than those of X-ray， the differences were statistically significant （P<0.05）. Conclusion： Spiral CT has a high accuracy rate for the classification of ankle fractures and the quality of postoperative reduction and internal fixation. It has a high diagnostic and therapeutic value， and can provide a diagnostic basis for the diagnosis and treatment of ankle fracture patients.

[Key words] Spiral CT Imaging features Ankle fracture Fracture classification Efficacy evaluation

First-authors address： Dongguan Hospital of Traditional Chinese Medicine， Dongguan 523000， China

踝關節骨折是一種臨床常見骨折疾病，該病的發病率呈逐年上升的趨勢，由于人們患病后對治療效果要求提高，因此應做到解剖復位，內固定適宜[1]。踝關節骨折包括多種骨折類型，不同的骨折類型采取手術及內固定治療效果存在差異，因此需對踝關節骨折患者進行術前精確分型及術后評估，以制定臨床治療方案，改善患者預后。踝關節的穩定性是由骨骼和韌帶共同決定的，由于結構較復雜，常規二維影像診斷易出現漏診和誤診現象，因此需借助三維影像進行診斷，以保證踝關節骨折的診斷和治療療效評估的準確性。

由于踝關節的解剖結構較復雜，采取傳統的影像診斷技術無法較準確的顯示出骨折關節面的塌陷和移位程度，進而提高漏診和誤診的發生率。……