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目的 :探讨螺旋CT对复杂骨关节损伤的诊断价值。方法 :采用回顾性方法 ,对 5 0例复杂骨关节损伤病人CT片进行分析。其中 31例同时做了X线平片和CT检查。将CT片与平片结果进行对照研究。结果 :5 0例病人 ,CT显示骨折 15 2处 ,关节脱位 2 5个 ,椎管狭窄 13例 ,脊髓损伤 12例 ,蛛网膜下腔出血 1例 ,胸水 4例 ,关节积液 6例 ,上颌窦积血 6处 ,鼓窦、乳突积血 4处 ,软组织损伤 10例。31例中CT显示骨折10 4处 ,平片显示 46处 ;CT显示关节损伤 2 1个 ,平片显示 9个 ;CT显示椎管狭窄 10例 ,脊髓损伤 9例 ,关节积液 5例 ,平片均未显示 ;CT显示椎弓畸形 1例、平片诊断椎弓骨折可能 ,经手术证实为畸形 ;股骨粗隆间骨折 1例 ,CT、平片均未显示。结论 :(1)螺旋CT能直观、准确判定骨折类型 ,骨折片大小、数目及位置 ;(2 )能充分显示骨折片移位对附近组织造成的损伤情况 ;(3)能充分显示关节损伤程度并判定其稳定性 ;(4 )对损伤骨关节周围的软组织改变显示清晰 ,对复杂骨关节损伤有很高的诊断价值 ,但对线性骨折显示欠佳 ,可造成漏诊 ,应采取其它检查方法避免
Objective: To investigate the diagnostic value of spiral CT in diagnosis of complex bone and joint injuries. Methods: A retrospective method was used to analyze CT images of 50 patients with complicated bone and joint injuries. Among them, 31 cases had X-ray and CT examination at the same time. CT and plain film results were compared. Results: Fifty cases of patients showed 15 2 fractures, 25 articular dislocations, 13 spinal stenosis, 12 spinal cord injuries, 1 case of subarachnoid hemorrhage, 4 cases of pleural effusion, 6 cases of joint effusion, Sinus hemorrhage 6, drum sinus, mastoid hemorrhage 4, soft tissue injury in 10 cases. 31 cases of CT showed fracture 104, plain film showed 46; CT showed joint injury 21, plain film showed 9; CT showed spinal stenosis in 10 cases, 9 cases of spinal cord injury, 5 cases of joint effusion, flat All cases were not shown. One case of vertebral arch deformity was diagnosed by CT, and the vertebral arch fractures were diagnosed as normal by operation. One case of intertrochanteric fractures was noticed by CT and plain radiography. Conclusion: (1) Spiral CT can directly and accurately determine the fracture type, the size, number and location of the fracture fragments; (2) It can fully display the damage caused by the fracture fragments in the nearby tissue; (3) And determine its stability; (4) the soft tissue around the injured joint showed a clear change in the diagnosis of complex bone and joint injury has a high diagnostic value, but the linear fracture showed poor, can cause missed diagnosis should be taken to avoid other inspection methods