莫海宾　潘枝婉　陈源凯

【摘要】 目的：探討多层螺旋CT（MSCT）与核磁共振（MRI）联合应用于腕关节损伤的诊断价值。方法：将2012年1月1日-2015年12月31日入住本院的80例腕关节损伤患者的检查结果分为三组，对照A组行单纯MRI检查，对照B组行单纯MSCT检查，观察组行MRI、MSCT联合应用检查，对比三组数据的差异。结果：在骨折和关节脱位检查方面，观察组骨折73处，脱位35处，观察组检出率显著高于其他两组，比较差异均有统计学意义（P<0.05），对照A组与对照B组检出率比较差异无统计学意义（P>0.05）。观察组骨折和关节脱位检出率为92.50%（74/80），对照A组为68.75%（55/80），对照B组为71.25%（57/80），观察组检出率显著高于其他两组，比较差异均有统计学意义（P<0.05）；对照A组与对照B组检出率比较差异无统计学意义（P>0.05）。在移位碎骨折片和隐匿性骨折检出方面，观察组检测移位碎骨折片36处，隐匿性骨折34处，对照A组发现移位碎骨折片率0，隐匿性骨折率97.05%；对照B组发现移位碎骨折片率94.44%，隐匿性骨折率11.76%。结论：MRI联合MSCT应用于腕关节的损伤能准确判断患者腕关节的整体状况，全面显示患者骨折、脱位、骨碎片、肌腱及皮下组织损伤等多方面的情况，具有准确性、全面性，具有极高的诊断价值。

【关键词】 多层螺旋CT； 核磁共振； 联合应用； 腕关节损伤； 影像特征； 诊断价值

The Application Features and Diagnostic Value of Multislice Spiral CT Combined with Magnetic Resonance Imaging in Wrist Injury/MO Hai-bin，PAN Zhi-wan，CHEN Yuan-kai.//Medical Innovation of China，2016，13（31）：123-127

【Abstract】 Objective：To investigate the application imaging features and diagnostic value of multi-slice spiral CT （MSCT） combined with magnetic resonance （MRI） in wrist injury.Method：A total of 80 patients with wrist in our hospital were selected from January 1，2012 to December 31，2015，they were divided into three groups， each group was respectively given simple MRI，MSCT and MRI combined with MSCT，the results of three groups were compared.Result：In the aspect of fracture and dislocation of inspection，observation group had 73 pieces with fractures and 35 pieces dislocation，significantly higher than the other two groups，there were statistically significant differences（P<0.05），control group A and control group B was no significant difference（P>0.05）.The detection rate of fracture and dislocation in the observation group was 92.50%，control group A was 68.75%，control group B was 71.25%，the detection rate of fracture and dislocation in observation group was significantly higher than that of the other two groups，the differences were statistically significant （P<0.05）；control group A and control group B was no significant difference（P>0.05）.The shift in the broken fracture detection and aspects of the occult fracture of the observation group had 36 pieces of broken fracture displacement detection and 34 pieces occult fracture in，the control group A found broken fracture shift rate of 0， the occult fracture rate of 97.05%；the control group B found broken fracture shift rate of 94.44%，the occult fracture rate of 11.76%.Conclusion：MRI combined with MSCT in wrist injury can accurately determine the overall condition of the patient's wrist，comprehensive display fracture patients，dislocation，bone fragments，tendon and subcutaneous tissue injury，with accuracy and comprehensiveness，it has high diagnostic value.

【Key words】 Multi-slice spiral CT； MRI； Combined； Wrist injury； Imaging features； Diagnostic value

First-authors address：Laibin Guangxi Zhuang Autonomous Region Peoples Hospital，Laibin 546100，China

doi：10.3969/j.issn.1674-4985.2016.31.036

腕关节是人体中结构最复杂、骨骼最多、活动最频繁的关节之一，由尺挠骨远端、1～5掌骨近端及8块腕骨组成。由于这一部位结构精巧，活动频繁，且应用较多，所以容易造成关节损伤[1]。在诊断中，患者多处于被动体位，X线片及轴位计算机断层扫描图像很难在骨骼重叠的情况下精确地表达损伤部位及损伤程度，不能为诊断提供详细的信息，导致诊断不明，治疗方法失误，延误患者的治疗[2-4]。……