| 冯吉庆,祁学强,曹华佗,贺世集,谢 斌.螺旋CT三维重建指导股骨转子间骨折分型及稳定性评估[J].,2024,(20):3996-3999 |
| 螺旋CT三维重建指导股骨转子间骨折分型及稳定性评估 |
| Effect of Spiral CT Three-Dimensional Reconstruction in Guiding Classification and Stability Evaluation of Intertrochanteric Femoral Fracture |
| 投稿时间：2024-04-30 修订日期：2024-05-26 |
| DOI：10.13241/j.cnki.pmb.2024.20.055 |
| 中文关键词: 股骨转子间骨折 X线 螺旋CT三维重建 Evans-Jensen分型 稳定性 |
| 英文关键词: Intertrochanteric Femoral Fracture X-Ray Spiral CT Three-Dimensional Reconstruction Evans-Jensen Classification Stability |
| 基金项目:延安市科技计划项目（2021YF-18） |
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| 中文摘要: |
| 摘要 目的：探究螺旋CT三维重建指导股骨转子间骨折（IFF）分型及稳定性评估的应用价值。方法：选取2022年1月-2023年11月于本院接受手术治疗的102例IFF患者为对象，所有患者均于术前接受X线、螺旋CT扫描，分析患者CT三维重建成像典型影像表现；以术中诊断的Evans-Jensen分型为"金标准"，评估CT三维重建对IFF分型、稳定性诊断的准确性。结果：102例IFF患者中，Evans-Jensen分型为Ⅰ型17例、Ⅱ型48例、Ⅲ型27例、Ⅳ型6例、Ⅴ型4例。术前CT三维重建诊断IFF分型的准确率为94.12%（Kappa值=0.864），明显高于术前X线片诊断IFF分型的准确率（84.31%、Kappa值=0.725），差异比较有统计学意义（P＜0.05）。术前CT三维重建对冠状位骨折、外侧壁不完整及骨折端不稳定的检出率均高于X线片（P＜0.05）。结论：螺旋CT三维重建对Evans-Jensen分型的诊断准确率较高，与术中诊断结果一致性较好，同时可准确呈现IFF骨折的详细解剖学变化。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the application value of spiral CT three-dimensional reconstruction in guiding classification and stability evaluation of intertrochanteric femoral fracture (IFF). Methods: A total of 102 patients with IFF who underwent surgical treatment in the hospital from January 2022 to November 2023 were selected as the subjects. All patients underwent X-ray and spiral CT scanning before surgery. The typical imaging manifestations of CT three-dimensional reconstruction were analyzed. With Evans-Jensen classification of intraoperative diagnosis as the gold standard, the accuracy of CT three-dimensional reconstruction in diagnosing the type and stability of IFF was evaluated. Results: In this study, Evans-Jensen classification results showed 17 cases of type I, 48 cases of type II, 27 cases of type III, 6 cases of type IV, and 4 cases of type V. The accuracy of preoperative CT three-dimensional reconstruction for diagnosing the type of IFF was 94.12% (Kappa value=0.864), which was significantly higher than that of preoperative X-ray (84.31%, Kappa value=0.725) (P<0.05). The detection rates of preoperative CT three-dimensional reconstruction for coronary fractures, incomplete lateral wall, and unstable fracture ends were higher than those of X-ray (P<0.05). Conclusion: Spiral CT three-dimensional reconstruction is accurate for diagnosing Evans-Jensen type of IFF, and is consistent with intraoperative diagnostic results. At the same time, it can accurately present detailed anatomical changes of IFF. |
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