摘要
目的比较高龄复杂性髋关节骨折患者全髋关节置换术(THA)术前应用CT三维重建与X线检查的诊断效能。方法回顾性分析2019年3月至2022年1月瑞金市中医院收治的84例高龄复杂性髋关节骨折患者的临床资料,所有患者于THA术前均实施CT三维重建扫描、X线检查,以手术结果为“金标准”,比较CT三维重建、X线检查诊断高龄复杂性髋关节骨折患者骨折类型[股骨头/颈骨折、粗隆间骨折、髋臼骨折、复合骨折]的准确度及关节内骨碎片情况的诊断效能。结果CT三维重建诊断高龄复杂性髋关节骨折患者骨折类型的准确度为96.43%,高于X线检查的85.71%,差异统计学意义(P<0.05)。CT三维重建与X线检查诊断高龄复杂性髋关节骨折患者关节内骨碎片的灵敏度比较差异无统计学意义;CT三维重建诊断高龄复杂性髋关节骨折患者关节内骨碎片的准确度、特异度(96.36%、94.05%)均高于X线检查(78.18%、76.19%),差异有统计学意义(P<0.05);三维重建与金标准的Kappa值为0.867,X线检查与金标准的Kappa值为0.490。结论高龄复杂性髋关节骨折患者THA术前应用CT三维重建诊断其骨折类型和关节内骨碎片情况的准确度较高,可为临床治疗提供有效参考信息。
Objective To compare the diagnostic efficacy of CT 3D reconstruction and X-ray examination before total hip arthroplasty(THA)in elderly patients with complex hip fractures.Methods The clinical data of 84 elderly patients with complex hip fracture admitted to Ruijin Hospital of Traditional Chinese Medicine from March 2019 to January 2022 were retrospectively analyzed.All patients underwent CT 3D reconstruction and X-ray examination before THA.With the surgical results were taken as the"gold standard",the accuracy of CT 3D reconstruction and X-ray exami-nation in the diagnosis of fracture types(femoral head/neck fracture,intertrochanteric fracture,acetabular fracture,compound fracture)in elderly pa-tients with complex hip fracture and the diagnosis of intra-articular bone fragments were compared.Results The accuracy of CT 3D reconstruction in diagnosing fracture types of elderly patients with complex hip fracture was 96.43%,which was higher than 85.71%of X-ray examination,and the differences were statistically significant(P<0.05).There was no significant difference in sensitivity between CT 3D reconstruction scan and X-ray examination in the diagnosis of intra-articular bone fragments in elderly patients with complex hip fractures;the accuracy and specificity of CT 3D reconstruction in the diagnosis of intra-articular bone fragments in elderly patients with complex hip fractures(96.36%,94.05%),which were higher than that of X-ray examination(78.18%,76.19%),and the differences were statistically significant(P<0.05);The Kappa value of 3D reconstruction and gold standard was 0.867,and that of X-ray examination and gold standard was 0.490.Conclusion The accuracy of 3D CT reconstruction in di-agnosing fracture types and bone fragments in the joints of elderly patients with complex hip fractures before THA is high,which can provide effec-tive reference information for clinical treatment.
作者
谢海棠
刘俊传
刘宝华
XIE Haitang;LIU Junchuan;LIU Baohua(Department of Radiology,Ruijin Hospital of Traditional Chinese Medicine,Ganzhou,Jiangxi,342500,China)
出处
《当代医学》
2024年第4期127-130,共4页
Contemporary Medicine
