Liu Xin-Ding, Wang Hai-Bo, Zhang Tie-Cheng, Wan Yong, Zhang Chu-Zhen
Department of CT, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China.
World J Clin Cases. 2020 Sep 26;8(18):4067-4074. doi: 10.12998/wjcc.v8.i18.4067.
Tibial plateau fracture is one of the common fracture types. It occurs mainly in teenagers and is usually caused by a fall. After the occurrence of fracture, knee swelling, pain, limited activity, . greatly affect the patient's exercise habits and lifestyle. X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) were used in this examination. X-rays are relatively new and easy to operate. However, there are some errors in the observation of fracture collapse and fracture displacement. In recent years, CT and MRI have been actively used to diagnose various types of clinical fractures. They have more diagnostic power than X-ray film. However, some scholars believe that CT is also prone to errors in clinical application. The volume effect leads to missed diagnosis and misdiagnosis in some cases, while the multidirection scanning of MRI technology can effectively overcome the shortcomings of CT. To facilitate the selection of clinical examination regimens, this study further observed the diagnostic ability of these two regimens in the diagnosis of tibial plateau fractures.
To explore the value of nuclear MRI and CT in the clinical diagnosis of tibial plateau fractures.
A total of 120 patients with tibial plateau fractures admitted from September 2017 to August 2019 were included. All patients were examined by nuclear MRI and CT scanning. The results were sent to senior physicians in our hospital to complete the diagnosis.
Nuclear magnetic resonance showed the same effects as CT in four aspects: fracture displacement, bone defect, fracture site and fracture comminution. There was no significant difference in the score data ( > 0.05). Nuclear magnetic resonance and CT tended to be consistent in the B3, C2 and C3 fracture diagnosis coincidence rate, combined injury detection rate and fracture detection rate. The diagnostic coincidence rate of type B1, B2 and C1 fractures and the accuracy rate of overall fracture classification indicated that the MRI technique was significantly better than that of CT ( > 0.05).
MRI and CT have good diagnostic typing in the diagnosis of tibial plateau fractures, but MRI is more accurate and may be preferred.
胫骨平台骨折是常见的骨折类型之一。主要发生于青少年，多由跌倒所致。骨折发生后，膝关节肿胀、疼痛、活动受限，严重影响患者的运动习惯和生活方式。本次检查采用了X线、计算机断层扫描（CT）及磁共振成像（MRI）。X线相对新颖且操作简便。然而，在观察骨折塌陷及骨折移位方面存在一些误差。近年来，CT和MRI已被积极用于诊断各类临床骨折。它们比X线片具有更强的诊断能力。然而，一些学者认为CT在临床应用中也容易出现误差。容积效应导致在某些情况下出现漏诊和误诊，而MRI技术的多方向扫描能够有效克服CT的缺点。为便于临床检查方案的选择，本研究进一步观察了这两种方案对胫骨平台骨折的诊断能力。
探讨核MRI与CT在胫骨平台骨折临床诊断中的价值。
纳入2017年9月至2019年8月收治的120例胫骨平台骨折患者。所有患者均接受核MRI及CT扫描检查。将结果送交我院 senior physicians 完成诊断。
核磁共振在骨折移位、骨缺损、骨折部位及骨折粉碎四个方面与CT表现相同。评分数据无显著差异（>0.05）。核磁共振与CT在B3、C2及C3型骨折诊断符合率、合并伤检出率及骨折检出率方面趋于一致。B1、B2及C1型骨折的诊断符合率及骨折总体分型准确率表明，MRI技术明显优于CT（>0.05）。
MRI和CT在胫骨平台骨折诊断中均具有良好的诊断分型，但MRI更准确，可能更具优势。
