影像科学与光化学 ›› 2020, Vol. 38 ›› Issue (3): 464-469.DOI: 10.7517/issn.1674-0475.191103

• 综述与论文 • 上一篇    下一篇

X线平片和CT扫描在外伤性脊椎骨折部位及解剖学改变诊断中的应用

罗德军, 杨博   

  1. 简阳市人民医院 骨科, 四川 简阳 641400
  • 收稿日期:2019-10-31 出版日期:2020-05-15 发布日期:2020-05-15
  • 通讯作者: 杨博

The Application of X-ray Plain Film and CT Scan in the Diagnosis of the Location and Anatomical Changes of Traumatic Vertebral Fracture

LUO Dejun, YANG Bo   

  1. Department of Orthopedics, Jianyang People's Hospital, Jianyang 641400, Sichuan, P. R. China
  • Received:2019-10-31 Online:2020-05-15 Published:2020-05-15

摘要: 分析X线平片和CT扫描对外伤性脊椎骨折部位的检出情况、骨折部位解剖学改变的显示情况,并对治疗效果进行评价。本研究选取2018年1月~2019年6月于我院进行手术治疗的外伤性脊椎骨折患者90例,所有患者均行X线平片和CT扫描检查,以手术结果为参考,观察X线平片和CT扫描对外伤性脊椎骨折部位(前柱、中柱、后柱)的检出情况、骨折部位解剖学改变(小关节滑脱、骨碎片、椎体移位、椎管狭窄)的显示情况,以及对术后椎弓根未完全到达椎体的检出情况。结果显示,CT扫描对中柱骨折、后柱骨折的诊断符合率均明显高于X线平片(P<0.05);对前柱骨折的诊断符合率与X线平片比较无差异(P>0.05)。CT扫描对小关节滑脱、骨碎片、椎体移位、椎管狭窄的诊断符合率均明显高于X线平片(P<0.05);对术后椎弓根未完全到达椎体检出率为88.89%,高于X线平片的77.78%,但差异无统计学意义(P>0.05)。CT扫描对外伤性脊椎骨折部位检出率及骨折部位解剖学改变的显示均优于X线平片,有利于临床治疗方案的制定,可作为外伤性脊椎骨折的首选诊疗检查方法。

关键词: 外伤性脊椎骨折, X线平片, CT扫描, 骨折部位, 解剖学改变

Abstract: In this study, the display of anatomical changes in fracture site and the evaluation of treatment effect of X-ray plain film and CT scan were investigated. We selected 90 patients with traumatic spinal fracture who received surgical treatment in our hospital from January 2018 to June 2019. All the patients were examined with X-ray plain film and CT scan. According to the results of the operation, the detection of X-ray plain film and CT scan in the location of traumatic spinal fracture (anterior column, middle column, posterior coloum) and the anatomical changes of the fracture site (facet joint slippage, bone fragments, vertebral displacement, spinal stenosis) and incomplete pedicle of vertebral arch were observed. We found the diagnostic coincidence rate of CT scan for middle column fracture and posterior column fracture was significantly higher than that of X-ray plain film (P<0.05). There was no significant difference between CT scan and X-ray plain film in the diagnosis of anterior column fracture (P>0.05). The accuracy of CT scan in the diagnosis of facet joint slippage, bone fragments, vertebral displacement and spinal stenosis was significantly higher than that of X-ray plain film (P<0.05). The detection rate of CT scan for incomplete pedicle of vertebral arch was 88.89%, higher than that of X-ray film (77.783%), but the difference was not statistically significant (P>0.05). This study demonstrated that CT scan is superior to X-ray plain film in the detection of anatomical changes of external fracture site, which is conducive to the formulation of clinical treatment plan and can be the first choice for diagnosis and treatment of traumatic fracture.

Key words: traumatic vertebral fracture, X-ray plain film, CT scan, fracture site, anatomical changes