摘要
目的 探讨64排螺旋CT在Lisfranc关节损伤的CT表现及诊断应用价值。方法 收集2014年1月~2015年1月本院首诊常规DR片漏诊,螺旋CT确诊的足Lisfranc关节损伤50例。回顾分析其DR及应用64排螺旋CT进行容积扫描后三维重建图像,就Lisfranc关节损伤、Lisfranc关节各柱损伤、Lisfranc关节中的各种骨折及脱位的检查情况与DR进行比较。结果 50例患者中,按Myerson标准进行分型：单内侧柱损伤有5例患者,单中间柱损伤有7例患者,单外侧柱损伤有4例患者,内侧柱伴中间柱损伤有13例,中间柱伴外侧柱损伤10例,三柱均损伤11例。DR确诊或疑似足Lisfranc关节损伤40例,漏诊10例;50例足Lisfranc关节64排螺旋CT均明确诊断。结论 足Lisfranc关节损伤以多柱损伤常见,其中以内侧柱和中间柱联合损伤最常见,其次是三柱同时受累,在三柱结构中中间柱最易受损。64排螺旋CT可以清晰显示Lisfranc关节损伤并准确诊断其损伤类型,对足Lisfranc关节损伤导致的骨折、脱位能明确诊断并显示损伤细节,具有诊断和指导治疗的应用价值。
Objective To evaluate The diagnostic value of 64 row volume CT in the Lisfranc injuries.Methods The clinical data was collected in 50 patients with fractures of Lisfranc joint from January 2014 to January 2015 which were missed on conventional X-ray iflm at ifrst diagnosis but diagnosed by 64 row volume CT. Volume data of scanning for 50 patients with Lisfranc injury were performed using DR and 64 row volume CT. The three-dimensional images were reconstructed, and the results were compared with the findings obstained from DR.Results There were 50 cases of Lisfranc injuries, including 5 cases of single medial column injury, 7 cases of middle column injuries,4 cases of single lateral column injury.13 cases with medial and middle column jujuries,10 cases with middle and lateral column injuries, and 11 cases with three column injuries by Myerson’s classification. 40 cases of Lisfranc injuries diagnosed by DR and 10 cases were mis-diagnosed; 50 cases of Lisfranc injuries were all diagnosed correctly by 64 row volume CT.ConclusionThe middle column combined with medial column injury is the most common injury in foot Lisfranc injury, and the second is the three column, which is the most easily damaged in the middle column of the three column structure. 64 row volume CT reconstruction images can show Lisfranc injury clearly, and accurately for it, which can also reveal fractures and dislocations Lisfranc injury. 64 row volume CT has great Application value of diagnosis and treatment.
出处
《中国继续医学教育》
2016年第24期68-69,共2页
China Continuing Medical Education
