多层螺旋 CT 对疑似腕舟骨骨折且 X 线检查阴性患者的诊断准确性。
Diagnostic accuracy of multidetector computed tomography for patients with suspected scaphoid fractures and negative radiographic examinations.
机构信息
Department of Radiology, Gulhane Military Medical Academy, Ankara, Turkey.
出版信息
Jpn J Radiol. 2011 Feb;29(2):98-103. doi: 10.1007/s11604-010-0520-3. Epub 2011 Feb 27.
PURPOSE
The aim of this prospective study was to evaluate the diagnostic accuracy of multidetector computed tomography (MDCT) in detecting occult scaphoid fractures.
MATERIALS AND METHODS
A total of 54 patients with a clinically suspected scaphoid fracture and negative initial conventional radiographs were evaluated with 64-row MDCT wrist examinations within 1 week of the trauma. The gold standard used was the diagnosis on MRI done within 1 week after MDCT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT were calculated.
RESULTS
MRI showed a total of 22 fractures in 20 of 55 (36%) wrists. Fractures included 14 scaphoid and 8 other carpal bones. MDCT showed a total of 19 fractures in 17 of 55 (30%) wrists. Two isolated scaphoid fractures and one trapezium fracture were missed on MDCT. The sensitivity, specificity, PPV, and NPV of MDCT were 86%, 100%, 100%, and 91%, respectively.
CONCLUSION
MDCT offers highly accurate results, especially concerning cortical involvement, and is a useful alternative in facilities lacking MRI.
目的
本前瞻性研究旨在评估多层螺旋 CT（MDCT）在检测隐匿性舟状骨骨折中的诊断准确性。
材料与方法
对 54 例临床疑似舟状骨骨折且初始常规 X 线片阴性的患者，在创伤后 1 周内行 64 排 MDCT 腕关节检查。金标准为 MDCT 后 1 周内行的 MRI 检查。计算 MDCT 的灵敏度、特异度、阳性预测值（PPV）和阴性预测值（NPV）。
结果
MRI 共显示 55 个腕关节中的 22 个骨折（36%），其中包括 14 例舟状骨和 8 例其他腕骨骨折。MDCT 共显示 55 个腕关节中的 19 个骨折（30%），漏诊了 2 例孤立性舟状骨骨折和 1 例舟骨骨折。MDCT 的灵敏度、特异度、PPV 和 NPV 分别为 86%、100%、100%和 91%。
结论
MDCT 提供了高度准确的结果，尤其是对皮质受累情况，对于缺乏 MRI 的医疗机构来说是一种有用的替代方法。
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