刘秋美

[摘要] 目的 為了提高临床对四肢骨关节骨折的检出率，探讨应用多层螺旋CT（MSCT）后处理技术诊断的价值和意义。方法 根据随机原则的相关要求从2016年11月—2017年11月来该院就诊的四肢骨关节骨折患者中方便选取110例作为研究对象，入组患者均先接受数字化X线摄影（DR）平片检查再接受多层螺旋CT检查，同时展开多平面重组（MPR）、表面阴影显示（SSD）和容积再现三维成像（VRT）技术等对后处理技术，比较两种检查方法对四肢骨关节骨折检出率的差异。结果 研究表明，入组患者中共发现骨折170处，其中经DR检查发现123根骨折，检出率为123/170（72.35%），经多层螺旋CT后处理技术检查发现，MPR、SSD和VRT发现骨折依次为163根、169根和170根，检出率依次为95.88%、99.41%和100.00%，两种检查方法进行配对检验发现，多层螺旋CT后处理技术诊断四肢骨关节骨折的准确率显著高于数字化X 线摄影平片，组间比较差异有统计学意义（χ2=35.22，P<0.05）。结论 四肢骨关节骨折应用多层螺旋CT后处理技术进行诊断，不仅无创，而且准确率高，能够明显降低漏诊和误诊率，值得临床应用。

[关键词] 四肢骨关节骨折；多层螺旋CT；影像诊断；后处理技术

[中图分类号] R683 [文献标识码] A [文章编号] 1674-0742（2018）06（c）-0190-03

[Abstract] Objective In order to improve the clinical detection rate of bone and joint fractures of the limbs， the value and significance of multi-slice spiral CT （MSCT） post-processing technique diagnosis are discussed. Methods According to the relevant requirements of the randomized principle， 110 patients with bone fractures of the limbs who came to the hospital from November 2016 to November 2017 were selected conveniently as the study subjects. All patients enrolled in the study received digital plain radiographs （DR） plain films. The examination was followed by a multi-slice spiral CT examination. At the same time， multi-planar reformation （MPR）， surface shadow display （SSD）， and volume rendering 3D imaging （VRT） techniques were used to post-process the technique. The two examination methods were compared for difference of fractures of the bones and joints of the extremities in the rate. Results Studies have shown that 170 patients were found to have fractures in the group of patients. Among them， 123 fractures were detected by DR examination. The detection rate was 123/170 （72.35%）. MPR， SSD and VRT were found after multi-slice spiral CT post-processing examination. The number of fractures was 163， 169， and 170， respectively. The detection rates were 95.88%， 99.41%， and 100.00%， respectively. Paired examinations using the two examination methods found that the accuracy of multi-slice spiral CT post-processing technique in diagnosing bone and joint fractures of limbs. Significantly higher than the digital radiographs， the difference between the groups was statistically significant （χ2=35.22， P< 0.05）. Conclusion The use of multi-slice spiral CT post-processing techniques for the diagnosis of limb and joint fractures of the limbs is not only non-invasive， but also has high accuracy， which can significantly reduce the rate of missed diagnosis and misdiagnosis， and is worthy of clinical application.

[Key words] Fracture of bone and joint of extremities； Multilayer spiral CT； Imaging diagnosis； Post-processing technique

四肢骨关节骨折是临床发生率较高的骨折类型之一，一旦发生会对患者的身心健康造成严重影响[1]。现阶段四肢骨关节骨折诊断中多采用X线平片技术，作为临床首选的影像学检查方法，在诊断隐匿性骨折过程中具有一定的局限性，很容易漏诊和误诊可疑骨折，延误患者最佳治疗时机[2]。四肢骨关节骨折患者通过多层螺旋CT后处理技术进行诊断，不仅可以快速准确的发生骨关节骨折损伤情况，还能为患者的后期治疗提高有价值的参考资料[3]。……