隐匿性胫骨平台骨折MRI、CT检查的影像学表现及其诊断价值对比的回顾性研究

目的:研究对比隐匿性胫骨平台骨折(TPOF)磁共振成像(MRI)、电子计算机断层扫描(CT)检查的影像学表现及其诊断价值。方法:回顾性分析我院自2016年1月至2019年12月拟诊断为TPOF且X线检查表现为阴性的89例患者的临床资料,分别对所有受试者进行MRI、CT检查,且以手术检查为金标准,比较上述两种影像学检查手段诊断TPOF的效能。此外,比较MRI、CT检查诊断TPOF的表观扩散系数以及节段各向异性值以及对TPOF类型的检出率。结果:MRI检查诊断TPOF的灵敏度、特异度及准确度分别为98.61%、94.12%、97.75%,均高于CT检查的79.17%、64.71%、76.40%(均P<0.05)。MRI检查诊断TPOF的表观扩散系数高于CT检查,而节段各向异性值低于CT检查(均P<0.05)。MRI检查对骨皮质骨折的检出率低于CT检查,而对骨小梁骨折的检出率高于CT检查(均P<0.05)。结论:MRI检查诊断TPOF的价值高于CT检查,且在骨小梁骨折的检出率方面优于CT检查,但CT检查应用于骨皮质骨折的诊断价值更高。临床工作中可能通过联合MRI以及CT检查,继而达到提高TPOF检出率的目的。

A Retrospective Study of MRI and CT Examination Imaging Findings and Their Diagnostic Value in Occulting Tibial Plateau Fractures

ABSTRACT Objective: To study and compare the imaging findings and diagnostic value of magnetic resonance imaging (MRI) and computed tomography (CT) examination in occulting tibial plateau fractures (TPOF). Methods: The clinical data of 89 patients with TPOF and X-ray examination showed negative from January 2016 to December 2019 in our hospital were retrospectively analyzed. All subjects were examined by MRI and CT examination respectively, and surgical examination was taken as the gold standard, and the efficacy of the above two imaging methods in the diagnosis of TPOF was compared. In addition, the apparent diffusion function, segmental anisotropy value and the detection rate of TPOF type were compared between MRI and CT examination. Results: The sensitivity, specificity and accuracy of MRI examination diagnosis of TPOF were 98.61%, 94.12% and 97.75%, respectively, which were all higher than those of CT examination of 79.17%, 64.71% and 76.40% respectively (all P<0.05). The apparent diffusion function of TPOF diagnosed by MRI examination was higher than that of CT examination, while the segmental anisotropy value was lower than that of CT examination (all P<0.05). The detection rate of cortical fractures of MRI examination was lower than that of CT examination, while the detection rate of trabecular fractures was higher than that of CT examination (all P<0.05). Conclusion: The value of MRI examination in the diagnosis of TPOF is higher than that of CT examination, and the detection rate of trabecular fracture is better than that of CT examination, but CT examination is more valuable in the diagnosis of cortical fracture. In clinical work, MRI and CT examination may be combined to improve the detection rate of TPOF.