膝关节外伤患者磁共振和64排螺旋CT诊断结果分析
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摘要
目的:观察对比膝关节外伤患者磁共振(MRI)和64排螺旋计算机断层扫描(CT)诊断结果。方法:选取珠海市遵义医学院附属第五医院2014年12月至2016年12月收治的60例膝关节外伤患者作为研究对象,采用数字表法将所有患者简单随机分为观察组和对照组,每组30例。对照组患者采用64排螺旋CT进行诊断,观察组患者采用磁共振弥散加权成像(DWI)的方法进行诊断。同时选取30例本院体检的正常人,并将其骨髓平均值与观察组患者的外伤性骨髓水肿患者、生理反应性骨髓水肿表观弥散系数(ADC)进行比较,并对比两组患者经过不同方式诊断后的确诊率、漏诊率、半月板损伤与韧带损伤评估情况,并观察患者骨挫伤愈合过程中的DWI动态变化特点。结果:诊断后,观察组患者的确诊率为100.00%,无漏诊率,均优于对照组,差异具有统计学意义(P<0.05);且观察组对半月板损伤与韧带损伤评估比较,差异无统计学意义(P>0.05);对照组对半月板损伤与韧带损伤的评估价值更高,与观察组相比具有统计学意义(P<0.05);同时,经DWI检查,患者外伤愈合过程中的DWI动态变化显示,外伤性骨髓水肿患者、生理反应性骨髓水肿患者的ADC值比较,差异具有统计学意义(P<0.05)。结论:在膝关节外伤患者的诊断中,DWI的诊断准确率高于64排螺旋CT,且ADC值对患者的鉴别诊断意义较大。
Objective To observe and compare the knee injury magnetic resonance and 64 slice spiral CT diagnosis.Methods 60 cases of knee joint trauma were selected from December 2014 to December 2016 were the Fifth Affiliated Hospital of Zunyi Medical College,Zhuhai city as the research object,using digital table method,all patients were randomly divided into observation group and control group,30 cases in each group.The control group underwent 64 slice CT diagnosis,observation group were treated by diffusion-weighted magnetic resonance imaging(DWI) diagnostic method.At the same time selected 30 cases of normal physical examination in our hospital,and the average value of bone marrow and bone marrow edema in patients with traumatic observation group of patients,the physiological response of the bone marrow edema ADC values were compared,and compared two groups of patients after different diagnosis after diagnosis rate,misdiagnosis rate,meniscus and ligament injury assessment,DWI and observe the dynamic changes of bone contusion in the healing process.Results after diagnosis,patients in the observation group the diagnosis rate was 100 %,no misdiagnosis rate was better than the control group and the observation group,P < 0.05:for the plate loss No statistically significant differences,injury and ligament damage assessment P > 0.05:control group evaluation of meniscus and ligament injury of higher value,compared with the observation group with statistical significance(P < 0.05):at the same time,the diffusion weighted magnetic resonance imaging in patients with trauma healing showed diffusion weighted magnetic resonance imaging dynamic changes in the process of traumatic bone marrow edema patients,there are significant differences between the physiological response of bone marrow edema in patients with ADCP < 0.05.Conclusion in the diagnosis of knee trauma,diagnosis of magnetic resonance diffusion-weighted imaging with high accuracy in the 64 row spiral CT,and the value of ADC in differential diagnosis of patients with greater significance,worthy of promotion.
Objective To observe and compare the knee injury magnetic resonance and 64 slice spiral CT diagnosis.Methods 60 cases of knee joint trauma were selected from December 2014 to December 2016 were the Fifth Affiliated Hospital of Zunyi Medical College,Zhuhai city as the research object,using digital table method,all patients were randomly divided into observation group and control group,30 cases in each group.The control group underwent 64 slice CT diagnosis,observation group were treated by diffusion-weighted magnetic resonance imaging(DWI) diagnostic method.At the same time selected 30 cases of normal physical examination in our hospital,and the average value of bone marrow and bone marrow edema in patients with traumatic observation group of patients,the physiological response of the bone marrow edema ADC values were compared,and compared two groups of patients after different diagnosis after diagnosis rate,misdiagnosis rate,meniscus and ligament injury assessment,DWI and observe the dynamic changes of bone contusion in the healing process.Results after diagnosis,patients in the observation group the diagnosis rate was 100 %,no misdiagnosis rate was better than the control group and the observation group,P < 0.05:for the plate loss No statistically significant differences,injury and ligament damage assessment P > 0.05:control group evaluation of meniscus and ligament injury of higher value,compared with the observation group with statistical significance(P < 0.05):at the same time,the diffusion weighted magnetic resonance imaging in patients with trauma healing showed diffusion weighted magnetic resonance imaging dynamic changes in the process of traumatic bone marrow edema patients,there are significant differences between the physiological response of bone marrow edema in patients with ADCP < 0.05.Conclusion in the diagnosis of knee trauma,diagnosis of magnetic resonance diffusion-weighted imaging with high accuracy in the 64 row spiral CT,and the value of ADC in differential diagnosis of patients with greater significance,worthy of promotion.
引文
[1]王宗博,牛广明,于静红,等.磁共振成像对膝关节急性软骨损伤的研究[J].医学影像学杂志,2016,26(10):1885-1890.
[2]曹建新,孔祥泉,王一民,等.膝关节双能量CT低剂量扫描对虚拟去钙图像质量及骨挫伤诊断的影响[J].临床放射学杂志,2015,34(10):1673-1678.
[3]Lange T.,Maclaren J.,Herbst M.et al.Knee cartilageMRI with in situ mechanical loading using prospective motion correction[J].Magnetic resonance in medicine:official journal of the Society of Magnetic Resonance in Medicine,2014,71(2):516-523.
[4]何春花.磁共振成像和X线检查在膝关节外伤诊断中的应用比较[J].实用医技杂志,2015,22(8):827-828.
[5]杨琳琳,陈世荣,向醒,等.高频超声评价膝关节骨性关节炎与内侧半月板突出的关系[J].临床超声医学杂志,2016,18(5):297-300.
[6]陈华勇,袁昆.磁共振成像诊断膝关节骨挫伤的价值及临、床意义[J].实用医技杂志,2016,23(9):964-966.
[7]Cao JX,Wang YM,Kong XQ,et al.Good interrater reliability of a new grading system in detecting traumatic bone marrow lesions in the knee by dual energy CT virtual non-calcium images[J].European Journal of Radiology,2015,84(6):1109-1115.
[8]Gill,Kara G.,Nemeth,Blaise A.,Davis,Kirkland W.et al.Magnetic Resonance Imaging of the Pediatric Knee[J].Magnetic resonance imaging clinics of North America,2014,22(4):743-763.
[9]海里力·吾甫力卡森.膝关节外伤后单纯性骨髓水肿的MRI表现及维吾尔医治疗分析[J].引文版:医药卫生,2015,1(7):187-188.
[10]张玉祥,赵春云,侯文生等.膝关节外伤交叉韧带持续性损伤的磁共振成像表现[J].山西医药杂志,2014,43(14):1658-1659.
[11]Singleton,J.A.G.,Walker,N.M.,Gibb,I.E.et al.Case suitability for definitive through knee amputation following lower extremity blast trauma:Analysis of 146combat casualties,2008-2010[J].Journal of the Royal Army Medical Corps,2014,160(2):187-190.
[12]陈焱森,李志铭.膝关节外伤性隐匿性骨折的MRI应用及价值分析[J].中华关节外科杂志(电子版),2014,8(1):28-30.
[13]许晓华,李皓,郭国强等.超声在膝关节及周围病变诊断中的应用价值[J].临床超声医学杂志,2012,14(8):559-561.
[14]李勇.膝关节外伤在磁共振和64排螺旋CT的诊断对比研究[J].中外医疗,2016,35(5):171-172.
[15]姚勇,赵美臣,唐鑫等.64层CT的MPR重建技术在急诊膝关节韧带损伤中的应用分析[J].医学影像学杂志,2013,23(11):1775-1777.
[2]曹建新,孔祥泉,王一民,等.膝关节双能量CT低剂量扫描对虚拟去钙图像质量及骨挫伤诊断的影响[J].临床放射学杂志,2015,34(10):1673-1678.
[3]Lange T.,Maclaren J.,Herbst M.et al.Knee cartilageMRI with in situ mechanical loading using prospective motion correction[J].Magnetic resonance in medicine:official journal of the Society of Magnetic Resonance in Medicine,2014,71(2):516-523.
[4]何春花.磁共振成像和X线检查在膝关节外伤诊断中的应用比较[J].实用医技杂志,2015,22(8):827-828.
[5]杨琳琳,陈世荣,向醒,等.高频超声评价膝关节骨性关节炎与内侧半月板突出的关系[J].临床超声医学杂志,2016,18(5):297-300.
[6]陈华勇,袁昆.磁共振成像诊断膝关节骨挫伤的价值及临、床意义[J].实用医技杂志,2016,23(9):964-966.
[7]Cao JX,Wang YM,Kong XQ,et al.Good interrater reliability of a new grading system in detecting traumatic bone marrow lesions in the knee by dual energy CT virtual non-calcium images[J].European Journal of Radiology,2015,84(6):1109-1115.
[8]Gill,Kara G.,Nemeth,Blaise A.,Davis,Kirkland W.et al.Magnetic Resonance Imaging of the Pediatric Knee[J].Magnetic resonance imaging clinics of North America,2014,22(4):743-763.
[9]海里力·吾甫力卡森.膝关节外伤后单纯性骨髓水肿的MRI表现及维吾尔医治疗分析[J].引文版:医药卫生,2015,1(7):187-188.
[10]张玉祥,赵春云,侯文生等.膝关节外伤交叉韧带持续性损伤的磁共振成像表现[J].山西医药杂志,2014,43(14):1658-1659.
[11]Singleton,J.A.G.,Walker,N.M.,Gibb,I.E.et al.Case suitability for definitive through knee amputation following lower extremity blast trauma:Analysis of 146combat casualties,2008-2010[J].Journal of the Royal Army Medical Corps,2014,160(2):187-190.
[12]陈焱森,李志铭.膝关节外伤性隐匿性骨折的MRI应用及价值分析[J].中华关节外科杂志(电子版),2014,8(1):28-30.
[13]许晓华,李皓,郭国强等.超声在膝关节及周围病变诊断中的应用价值[J].临床超声医学杂志,2012,14(8):559-561.
[14]李勇.膝关节外伤在磁共振和64排螺旋CT的诊断对比研究[J].中外医疗,2016,35(5):171-172.
[15]姚勇,赵美臣,唐鑫等.64层CT的MPR重建技术在急诊膝关节韧带损伤中的应用分析[J].医学影像学杂志,2013,23(11):1775-1777.