Department of Radiology, The Second Hospital of Yinzhou, Ningbo, Zhejiang 315100, China.
Scanning. 2022 Sep 16;2022:7686485. doi: 10.1155/2022/7686485. eCollection 2022.
To explore the application value of low-dose CT and MRI in the evaluation of soft tissue injury in tibial plateau fractures.
This study included 89 patients with high suspicion of TPF and KI admitted to our hospital from July 2015 to May 2021. After arthroscopy, 81 patients were diagnosed with FTP combined with KI. The Schatzker classification based on X-ray and CT plain scan combined with three-dimensional reconstruction was recorded, and the soft tissue injury was recorded according to the MRI examination of the affected knee joint.
With the results of pathological examination and arthroscopic surgery as the gold standard, the results of MRI and pathological examination and arthroscopic examination were in good agreement (Kappa = 0.857, 0.844), and CT was moderately in agreement (Kappa = 0.697, 0.694). In KI examination, CT and MRI had no difference in the evaluation of ligament injury and bone injury ( > 0.05), but MRI had better diagnostic effect on meniscus injury ( < 0.05). Finally, the satisfaction survey showed that patients in the CT group were more satisfied with clinical services ( < 0.05).
Both CT and MRI have certain diagnostic value for occult tibial plateau fractures, among which CT examination is more advantageous for trabecular bone fractures, MRI examination is more advantageous for cortical bone fractures, and MRI examination can improve occult tibial plateau fracture inspection accuracy.
探讨低剂量 CT 和 MRI 在胫骨平台骨折软组织损伤评估中的应用价值。
本研究纳入 2015 年 7 月至 2021 年 5 月我院收治的 89 例高度怀疑 TPF 和 KI 的患者。关节镜检查后，81 例患者诊断为 FTP 合并 KI。记录基于 X 线和 CT 平扫联合三维重建的 Schatzker 分类，并根据膝关节 MRI 检查记录软组织损伤情况。
以病理检查和关节镜手术结果为金标准，MRI 与病理检查和关节镜检查结果一致性较好（Kappa=0.857，0.844），CT 为中度一致性（Kappa=0.697，0.694）。在 KI 检查中，CT 和 MRI 在韧带损伤和骨损伤的评估中无差异（>0.05），但 MRI 对半月板损伤的诊断效果更好（<0.05）。最后，满意度调查显示 CT 组患者对临床服务更满意（<0.05）。
CT 和 MRI 对隐匿性胫骨平台骨折均具有一定的诊断价值，其中 CT 检查对松质骨骨折更有优势，MRI 检查对皮质骨骨折更有优势，MRI 检查能提高隐匿性胫骨平台骨折的检出准确率。
