MRI在膝关节隐性创伤骨折中诊断价值及其分型研究.docVIP

MRI在膝关节隐性创伤骨折中诊断价值及其分型研究 　　[摘要]目的 探讨MRI对膝关节隐性创伤骨折的临床诊断价值，分析膝关节隐性创伤骨折的MRI分型。方法 选取2013年1月～2016年12月我院接收的130例疑似膝关节隐性创伤骨折患者作为研究对象，所有患者均接受螺旋CT、MRI检查，以手术诊断结果作为诊断参照，比较螺旋CT、MRI对膝关节隐性创伤骨折的诊断灵敏度、特异度、准确性，分析膝关节隐性创伤骨折的MRI分型。结果 MRI对膝关节隐性创伤骨折的诊断灵敏度、特异度、准确性分别为94.23%、96.15%、94.61%，均高于螺旋CT的83.65%、76.92%、82.31%，差异有统计学意义（P0.05）。MRI与手术诊断结果一致性良好，而螺旋CT与手术诊断结果一致性仅为中等。膝关节隐性骨内骨折的MRI表现为T1WI低信号、T2WI混杂信号，隐性骨软骨骨折的MRI表现为T1WI低信号、T2WI高信号，隐性骨皮质骨折的MRI表现为T1WI中低信号、T2WI高信号。结论 MRI对膝关节隐性创伤骨折的诊断准确性较高，能够对各类膝关节隐性创伤骨折进行准确诊断，可作为螺旋CT诊断膝关节隐性创伤骨折的补充手段，减少漏诊、误诊。 　　[关键词]膝关节；隐性创伤骨折；诊断；MRI 　　[中图分类号] R683.42 [文献标识码] A [文章编号] 1674-4721（2017）03（c）-0098-03 　　[Abstract]Objective To investigate the clinical value of MRI in the diagnosis of occult fracture of knee joint，and to analyze the MRI classification of occult fracture of knee joint.Methods From January 2013 to December 2016，130 cases of suspected knee occult traumatic fracture patients in our hospital were selected as the research object，all patients underwent spiral CT and MRI examination，surgical diagnosis results was set as the diagnostic reference，the diagnostic sensitivity，specificity and accuracy on occult traumatic fracture of the knee joint were compared between spiral CT and MRI，and the occult traumatic fracture of the knee joint MRI type were analyzed.Results The diagnostic sensitivity，specificity and accuracy of MRI of occult traumatic fracture of the knee joint were 94.23%，96.15% and 94.61%，which was higher than that of spiral CT （83.65%，76.92%，82.31%），with significant difference （P0.05）.The diagnostic results of MRI diagnosis and surgery results had good agreement，and the spiral CT diagnosis and surgery results consistency only had moderate.In knee occult intraosseous fracture of MRI，there were T1WI low signal and T2WI mixed signal，occult osteochondral fracture MRI showed low T1WI signal and high T2WI signal，recessive cortical fracture MRI showed low signal and high T2WI signal T1WI.Conclusion The diagnostic accuracy of MRI in occult traumatic fractu