目的 分析多层螺旋CT联合MRI在不同类型隐匿性骨折中的诊断效能.方法 选择122例疑似隐匿性骨折患者为研究对象,均给予多层螺旋CT、MRI检查,分析不同类型隐匿性骨折患者的影像学表现,比较多层螺旋CT、MRI、多层螺旋CT联合MRI的诊断效能.结果 疲劳性骨折与衰竭性骨折患者螺旋CT多见断端模糊、无错位骨折线,MRI表现为线样T1WI信号、T2WI高低混杂信号、STIR明显高信号特征;隐性创伤骨折多层螺旋CT多见清晰锐利、无错位骨折线,MRI表现为线样或片状T1WI低信号与T2WI高信号特征;隐性骨内骨折多层螺旋CT多无异常表现,MRI可见不规则或片状T1WI低信号与T2WI高信号特征;122例受检对象中,MSCT检出39例,误诊10例,灵敏度、特异度、准确度分别为52.70%、79.17%、63.11%;MRI检出63例,误诊7例,灵敏度、特异度、准确度分别为85.14%、85.42%、85.25%;MSCT+ MRI检出69例,误诊4例,灵敏度、特异度、准确度分别为93.24%、91.67% 、92.62%.结论 MRI诊断隐匿性骨折具有较高的灵敏度与准确度,多层螺旋CT联合MRI检查有利于提高隐匿性骨折的诊断效能.
Objective To analyze the diagnostic efficacy of multi-slice spiral CT combined with MRI in the diagnosis of occult fracture of different types.Methods One hundred and twenty-two cases of suspected occult fracture were selected and tested with multi-slice spiral CT combined with MRI.The imaging manifestations of patients with different types of occult fracture were analyzed,and the diagnostic efficacy of multi-slice spiral,multi-slice spiral CT combined with MRI were compared.Results The images of spiral CT of the patients with fatigue fracture and failure fracture mostly showed broken end of fuzzy and no dislocation fracture line;the MRI presented the line T1WI signal,T2WI high and low mixed signal and STIR noticeable high signal characteristics.The images of multi-slice spiral CT of occult traumatic fracture showed clear and sharp line but no dislocation of fracture line.MRI performance showed line like or flake,T1WI low signal characteristics and T2WI high signal characteristics.Multi layer CT images of occult bone fractures showed no abnormal manifestations.MRI showed visible irregular or patchy T1WI low signal and T2WI high signal characteristics.Among 122 cases detected,39 cases were detected by MSCT,but 10 cases were misdiagnosed.The sensitivity,specificity and accuracy were respectively 52.70%,79.17% and 63.11%.Sixty-three cases were detected by MRI,7 cases were misdiagnosed.The sensitivity,specificity and accuracy were respectively 85.14%,85.42% and 85.25%.Sixty-nine cases were detected by MSCT + MRI,4 cases were misdiagnosed.The sensitivity,specificity and accuracy were respectively 93.24%,91.67% and 92.62%.Conclusions MRI has high sensitivity and accuracy in the diagnosis of occult fracture and multi-slice spiral CT combined with MRI is beneficial to improve the diagnostic efficiency of occult fracture.