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

doi:10.7517/issn.1674-0475.191103

Abstract

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

LUO Dejun, YANG Bo. The Application of X-ray Plain Film and CT Scan in the Diagnosis of the Location and Anatomical Changes of Traumatic Vertebral Fracture[J]. Imaging Science and Photochemistry, 2020, 38(3): 464-469.

References

[1] Pizones J, Izquierdo E, Alvarez P, et al. Impact of magnetic resonance imaging on decision making for thoracolumbar traumatic fracture diagnosis and treatment[J]. European Spine Journal, 2011,20(3):390-396.
[2] 刘冬雄,蔡碧红.基于外伤性脊椎骨折的多层螺旋CT三维重建技术与X线平片技术诊断效果对比[J].首都食品与医药,2019,26(21):89-90. Liu D X, Cai B H. Comparison of three-dimensional reco-nstruction technology of multi-slice spiral CT and X-ray plain film technology in the diagnosis of traumatic spinal fracture[J]. Capital Food Medicine, 2019,26(21):89-90.
[3] 陆庭斌. 放射平片与CT应用于脊柱骨折的诊断价值比较[J]. 临床医学研究与实践, 2018,3(19):157-158. Lu T B. Comparison of the diagnostic value of radiographs and CT in spine fracture[J]. Clinical Medicine Research and Practice, 2018,3(19):157-158.
[4] 姜国良. 放射DR平片与CT在脊椎骨折诊断中的应用价值分析[J]. 影像研究与医学应用, 2019,3(7):168-169. Jiang G L. Analysis of the application value of radiation DR plain film and CT in the diagnosis of spinal fracture[J]. Imaging Research and Medical Application, 2019,3(7):168-169.
[5] 吴炳洪, 周智强, 郑坚新, 等. 探讨X线平片、CT及磁共振成像对脊椎骨折的不同诊断价值[J]. 中国医学工程, 2017,25(9):16-19. Wu B H, Zhou Z Q, Zheng J X, et al. To explore the different diagnostic value of X-ray plain film, CT and MRI for vertebral fracture[J]. Chinese Medical Engineering, 2017,25(9):16-19.
[6] 陈小峰. 螺旋CT和X线平片诊断基层医院收治脊椎骨折效果对比研究[J]. 当代医学, 2015,21(24):25-26. Chen X F. Comparative study on the effect of spiral CT and X-ray plain film in the diagnosis of spinal fracture in primary hospitals[J]. Contemporary Medicine, 2015,21(24):25-26.
[7] 陈南霞. CT磁共振成像与X线诊断脊椎骨折的影像学对比[J]. 基层医学论坛, 2019,23(5):676-677. Chen N X. Imaging comparison between CT MRI and X-ray diagnosis of vertebral fracture[J]. Basic Medical Forum, 2019,23(5):676-677.
[8] 蒋兴. 脊椎骨折诊断中应用CT、磁共振成像与X线诊断价值[J]. 中国卫生标准管理, 2018,9(14):132-133. Jiang X. The value of CT, MRI and X-ray in the diagnosis of spinal fracture[J]. China Health Standard Management, 2018,9(14):132-133.
[9] 黄卫锋. 用多层螺旋CT检查与X线平片检查诊断脊椎骨折的效果对比[J]. 当代医药论丛, 2018,16(12):186-187. Huang W F. Comparison of the effect of multi-slice spiral CT and X-ray plain film in the diagnosis of spinal fracture[J]. Contemporary Medical Review, 2018,16(12):186-187.
[10] 黄海营, 张洪波, 洪强, 等. X线片与MRI联合应用对提高脊柱骨折的检出率与诊断准确性[J]. 华南国防医学杂志, 2018,32(5):321-323, 327. Huang H Y, Zhang H B, Hong Q, et al. Combined application of X-ray and MRI improves detection rate and diagnosis accuracy of spinal fracture[J]. South China Journal of National Defense Medicine, 2018,32(5):321-323, 327.
[11] 乔永明. X线平片与CT检查诊断脊椎骨折88例分析[J]. 河南医学高等专科学校学报, 2017,29(4):310-311. Qiao Y M. Analysis of 88 cases of vertebral fracture diagnosed by X-ray and CT[J]. Journal of Henan Medical College, 2017,29(4):310-311.
[12] 高维仁,赵慧娟.X线平片技术和多层螺旋CT三维重建技术在外伤性脊椎骨折诊断中的效果差异[J].中国实用医刊,2016,43(3):90-91. Gao W R, Zhao H J. The difference between X-ray plain film and multi-slice spiral CT 3D reconstruction in the diagnosis of traumatic vertebral fracture[J]. Chinese Journal of Practical Medicine, 2016,43(3):90-91.
[13] 车红英,祁方宇. 螺旋CT与X线摄片诊断脊椎骨折的临床价值分析[J]. 医学影像学杂志, 2016,26(7):1345-1348. Che H Y, Qi F Y. Analysis of the clinical value of spiral CT and X-ray in the diagnosis of spinal fracture[J]. Journal of Medical Imaging, 2016,26(7):1345-1348.
[14] Dugarte A J, Tkany L, Schroder L K, et al. Comparison of 2versus 3 dimensional fracture mapping strategies for 3 dimensional computerized tomography reconstructions of scapula neck and body fractures[J]. Journal of Orthopaedic Research, 2018,36(1):265-271.
[15] 杨志永. 多层面螺旋CT三维重建对脊椎骨折的临床诊断价值研究[J]. 中国CT和MRI杂志, 2016,14(11):118-120. Yang Z Y. Study on the clinical value of 3D reconstruction of multi-slice spiral CT in the diagnosis of spinal fracture[J]. Chinese Journal of CT and MRI, 2016,14(11):118-120.
[16] 张海燕. X线平片技术和多层螺旋CT三维重建技术在外伤性脊椎骨折诊断中的效果差异[J]. 中国医药指南, 2019,17(1):41-42. Zhang H Y. Difference between X-ray plain film technique and multi-slice spiral CT three-dimensional reconstruction technique in the diagnosis of traumatic vertebral fracture[J]. Chinese Medical Guide, 2019,17(1):41-42.
[17] 李剑. 多层面螺旋CT三维重建对脊椎骨折的临床诊断价值研究[J]. 现代医用影像学, 2018,27(8):2633-2634. Li J. Study on the clinical diagnosis value of 3D reconstruction of multi-slice spiral CT for vertebral fracture[J]. Modern Medical Imaging, 2018,27(8):2633-2634.
[18] Soodmand E, Zheng G, Steens W, et al. Surgically relevant morphological parameters of proximal human femur:a statistical analysis based on 3D reconstruction of CT data[J]. Orthopaedic Surgery, 2019,11(1):135-142.