摘要
目的分析肱骨髁上骨折GartlandⅠ型的数字化X线摄影(DR)影像学征象,旨在提高临床对其的认识,减少漏诊。方法选取131例肱骨髁上骨折GartlandⅠ型骨折患儿作为研究对象,均进行CT和DR检查。以CT三维重建诊断作为金标准,分析GartlandⅠ型骨折DR影像学征象,并统计其漏诊率;比较肱骨髁上骨折GartlandⅠ型DR单一征象与综合征象漏诊率。结果肱骨髁上骨折GartlandⅠ型骨折的DR影像学征象包括骨皮质起皱征、骨小梁中断征、肱骨髁窝“X”白线中断征、脂肪垫“八”字征、综合征象(两种或两种以上骨折征象),CT三维重建显示率分别为16.0%、20.6%、13.0%、9.2%、41.2%,DR影像学漏诊率分别为4.8%、7.4%、11.8%、83.3%、0。DR综合征象漏诊率0低于单一征象漏诊率的19.5%,差异有统计学意义(P<0.05)。结论DR影像学征象中综合征象(两种或两种以上骨折征象)是诊断肱骨髁上骨折GartlandⅠ型的主要影像学观察点,DR影像单一征象是GartlandⅠ型骨折漏诊的主要原因,其中脂肪垫“八”字征是GartlandⅠ型骨折最可能漏诊的影像学征象;骨皮质起皱、骨小梁中断、肱骨髁窝“X”白线中断、脂肪垫“八”字征对GartlandⅠ型骨折的诊断具有重要意义。
Objective To analyze the digital radiography(DR)imaging findings of Gartland typeⅠhumerus supracondylar fracture in order to improve understanding and reduce missed diagnosis.Methods 131 cases of Gartland typeⅠhumerus supracondylar fracture were selected as the study subjects,all of which were examined by CT and DR.Taking CT three-dimensional reconstruction diagnosis as the gold standard,DR imaging signs of Gartland typeⅠfracture were analyzed,and the rate of missed diagnosis was calculated.The rate of missed diagnosis of DR single versus comprehensive signs of Gartland typeⅠsupracondylar humerus fractures was compared.Results The DR imaging findings of Gartland typeⅠsupracondylar humerus fractures included cortical wrinkle sign,trabecular bone interruption sign,"X"white line interruption sign in humeral condylar fossa and"eight"sign of fat pad,and comprehensive signs(two or more fracture signs).The display rates of CT 3D reconstruction were 16.0%,20.6%,13.0%,9.2%and 41.2%,respectively.The missed diagnosis rates of DR imaging were 4.8%,7.4%,11.8%,83.3%and 0,respectively.The missed diagnosis rate of comprehensive sign was 0,which was lower than 19.5%of single sign,and the difference was statistically significant(P<0.05).Conclusion Comprehensive signs(two or more fracture signs)is the main DR imaging observation point for the diagnosis of Gartland typeⅠhumerus supracondylar fracture.The single sign of DR image is the main reason for the missed diagnosis of Gartland typeⅠfracture,and the"eight"sign of fat pad is the most likely imaging sign of Gartland typeⅠfracture.The cortical wrinkling sign,the disorder of trabecula bone interruption sign,the"X"white line interruption sign in humeral condylar fossa and the"eight"sign of fat pad are of great significance for the diagnosis of Gartland typeⅠfracture.
作者
刘开华
LIU Kai-hua(Department of Radiology,Xiantao First People's Hospital Affiliated to Yangtze University,Xiantao 433000,China)
出处
《中国现代药物应用》
2024年第6期92-95,共4页
Chinese Journal of Modern Drug Application
