[1]张滔,李兰,但倩,等.螺旋CT三维重建技术评估胫骨远端三平面骨折的价值[J].中国医学物理学杂志,2025,42(11):1445-1449.[doi:DOI:10.3969/j.issn.1005-202X.2025.11.006]
　ZHANG Tao,LI Lan,DAN Qian,et al.Value of spiral CT three-dimensional reconstruction technique in evaluating triplane fractures of the distal tibia[J].Chinese Journal of Medical Physics,2025,42(11):1445-1449.[doi:DOI:10.3969/j.issn.1005-202X.2025.11.006]
点击复制

螺旋CT三维重建技术评估胫骨远端三平面骨折的价值()

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
42
期数:
2025年第11期
页码:
1445-1449
栏目:
医学影像物理
出版日期:
2025-11-28

文章信息/Info

Title:
Value of spiral CT three-dimensional reconstruction technique in evaluating triplane fractures of the distal tibia
文章编号:
1005-202X（2025）11-1445-05
作者:
张滔; 李兰; 但倩; 吴俊华; 吴海燕; 刘愉勤
四川省骨科医院医学影像科， 四川 成都 610041
Author(s):
ZHANG Tao;  LI Lan;  DAN Qian;  WU Junhua;  WU Haiyan;  LIU Yuqin
Department of Medical Imaging, Sichuan Orthopedic Hospital, Chengdu 610041, China
关键词:
螺旋CT; X线检查; 三维重建技术; 胫骨远端; 三平面骨折
Keywords:
Keywords: spiral CT X-ray examination three-dimensional reconstruction technique distal tibia triplane fracture
分类号:
R816.8
DOI:
DOI:10.3969/j.issn.1005-202X.2025.11.006
文献标志码:
A
摘要:
目的：分析螺旋CT三维重建技术评估胫骨远端三平面骨折的价值。方法：回顾性分析2021年1月~2023年3月四川省骨科医院收治的183例胫骨远端三平面骨折患者的临床资料，患者均接受X线检查和螺旋CT检查，以手术复位结果为诊断金标准，分析X线检查和螺旋CT三维重建技术评估胫骨远端三平面骨折类型的诊断准确度。结果：183例胫骨远端三平面骨折患者根据骨折块的数目分型：四部分型44例，三部分型62例，二部分型77例；根据胫骨远端的骨骺损伤位置分型：外侧型175例，内侧型8例；根据骨折线是否累及关节面：Ⅰ型94例、Ⅱ型60例、Ⅲ型29例。X线对骨折块数目诊断分型，9例四部分型误诊为三分部型或二部分型，21例三部分型误诊为二部分型，其骨折块诊断分型准确率为83.60%。X线对骨折线与关节面位置诊断分型，39例存在误诊或不能精确诊断，其骨折线情况分型诊断准确率为78.69%。螺旋CT三维重建技术对骨折块数目诊断分型仅有1例四部分型误诊为三分部型，2例三部分型误诊为四部分型或二部分型，其骨折块分型诊断准确率为98.36%。螺旋CT三维重建技术对骨折线与关节面位置诊断，8例存在误诊，其骨折线情况分型诊断准确率为95.63%。结论：螺旋CT三维重建技术能立体显示胫骨远端三平面骨折的部位、形态、类型、关节面等空间信息，分型诊断准确率高，在胫骨远端三平面骨折复位治疗中具有较高应用价值。
Abstract:
Abstract: Objective To analyze the practical value of spiral CT three-dimensional reconstruction techniquein evaluating triplane fractures of the distal tibia. Methods A retrospective analysis was conducted on183 patients with triplane fractures of the distal tibia admitted to Sichuan Orthopedic Hospital from January 2021 to March 2023. All patients underwent both X-ray and spiral CT examinations. Taking surgical reduction results as the gold standard for diagnosis, the diagnostic accuracies of X-ray examination and spiral CT three-dimensional reconstruction technique for triplane fractures of the distal tibia were analyzed. Results Fracture classification according to the number of fracture fragments showed that among the 183 patients with triplane fractures of the distal tibial, there were 44 cases of four-part fractures, 62 cases of three-part fractures, and 77 cases of two-part fractures. The classification by the location of epiphyseal injury in the distal tibia showed 175 cases of lateral type and 8 cases of medial type. According to whether the fracture line involved the articular surface, they were categorized into 94 cases of type I, 60 cases of type II, and 29 cases of type III. For the classification of the number of fracture fragments, X-ray misdiagnosed 9 cases of four-part fractures as three-part or two-part fractures, and 21 cases of three-part fractures as two-part fractures, resulting in a diagnostic accuracy of 83.60%. For theclassification of fracture line and articular surface position, X-ray led to misdiagnosis or inaccurate diagnosis in 39 cases, with a diagnostic accuracy of 78.69%. When spiral CT three-dimensional reconstruction technique was used to classify the number of fracture fragments, only 1 case of four-part fracture was misdiagnosed as three-part fracture, and 2 cases of three-part fractures were misdiagnosed as four-part fractures or two-part fractures, yielding a diagnostic accuracy of 98.36%. For the diagnosis of the positional relationship of the fracture line to the articular surface,spiral CT three-dimensional reconstruction technique had 8 misdiagnoses, with a corresponding diagnostic accuracy of 95.63%. Conclusion Spiral CT three-dimensional reconstruction technique can stereoscopically display the spatial information of the triplane fractures of the distal tibia, such as the location, shape, type, and articular surface, exhibiting high accuracy for classification diagnosis and significant application value in the reduction and treatment of triplane fractures of the distal tibia.

相似文献/References:

[1]梁 健.64排螺旋CT结肠成像技术诊断结直肠疾病的有效性分析[J].中国医学物理学杂志,2015,32(03):447.[doi:10.3969/j.issn.1005-202X.2015.03.033]
[2]沈奕晨,聂生东.锥形束CT与螺旋CT图像配准算法及其在放疗中的应用[J].中国医学物理学杂志,2014,31(05):5151.[doi:10.3969/j.issn.1005-202X.2014.05.013]
[3]刘东旭,周丹,王利峰. 胆囊癌及其病灶局部侵犯的MRI诊断及影像学特征[J].中国医学物理学杂志,2019,36(3):322.[doi:DOI:10.3969/j.issn.1005-202X.2019.03.015]
　LIU Dongxu,ZHOU Dan,WANG Lifeng. MRI features and diagnosis of gallbladder carcinoma and local invasion of gallbladder carcinoma[J].Chinese Journal of Medical Physics,2019,36(11):322.[doi:DOI:10.3969/j.issn.1005-202X.2019.03.015]
[4]何小红,纪久雨,陈英杰.256排螺旋CT鉴别诊断乏脂性肾血管平滑肌脂肪瘤和非透明细胞肾癌的价值分析[J].中国医学物理学杂志,2020,37(12):1520.[doi:DOI:10.3969/j.issn.1005-202X.2020.12.009]
　HE Xiaohong,JI Jiuyu,CHEN Yingjie.Value of 256-slice spiral CT in the differential diagnosis of renal angiomyolipoma with minimal fat and non-clear cell renal cell carcinoma[J].Chinese Journal of Medical Physics,2020,37(11):1520.[doi:DOI:10.3969/j.issn.1005-202X.2020.12.009]
[5]刘胜,范承武.CT诊断重症肺炎支原体肺炎的价值[J].中国医学物理学杂志,2021,38(7):842.[doi:DOI:10.3969/j.issn.1005-202X.2021.07.010]
　LIU Sheng,FAN Chengwu.Value of CT in diagnosing severe Mycoplasma pneumoniae pneumonia[J].Chinese Journal of Medical Physics,2021,38(11):842.[doi:DOI:10.3969/j.issn.1005-202X.2021.07.010]
[6]赵德春,余可斌,刘嘉,等.不同心率前后门控CT冠状动脉成像图像质量与辐射剂量的相关性分析[J].中国医学物理学杂志,2024,41(2):185.[doi:DOI:10.3969/j.issn.1005-202X.2024.02.010]
　ZHAO Dechun,YU Kebin,LIU Jia,et al.Correlations between image quality and radiation dose in prospective and retrospective ECG-gated CT coronary angiography in patients with different heart rates[J].Chinese Journal of Medical Physics,2024,41(11):185.[doi:DOI:10.3969/j.issn.1005-202X.2024.02.010]
[7]武月华,张爽,王泽正.螺旋CT及三维重建技术诊断颌面部骨折的价值[J].中国医学物理学杂志,2024,41(11):1357.[doi:DOI:10.3969/j.issn.1005-202X.2024.11.006]
　WU Yuehua,ZHANG Shuang,WANG Zezheng.Diagnostic value of spiral CT and three-dimensional reconstruction in maxillofacial fracture[J].Chinese Journal of Medical Physics,2024,41(11):1357.[doi:DOI:10.3969/j.issn.1005-202X.2024.11.006]
[8]蒋晓兰,尹静,周礼平.320排螺旋CT不同时相选择方式对冠状动脉综合征的诊断价值[J].中国医学物理学杂志,2026,43(9):1196.[doi:DOI:10.3969/j.issn.1005-202X.2026.09.006]
　JIANG Xiaolan,YIN Jing,ZHOU Liping.Diagnostic value of different phase selection strategies of 320-row spiral CT in coronary syndrome[J].Chinese Journal of Medical Physics,2026,43(11):1196.[doi:DOI:10.3969/j.issn.1005-202X.2026.09.006]

备注/Memo

备注/Memo:
【收稿日期】2025-01-13 【基金项目】四川省中医药管理局科学技术研究专项（2020LC0174） 【作者简介】张滔，主管技师，研究方向：骨肌系统影像技术，E-mail: sgkzt00@163.com
更新日期/Last Update: 2025-12-01