螺旋CT在外伤性腕骨脱位或骨折-脱位诊断中的价值 postprint

Abstract: Objective To evaluate the diagnostic value of spiral CT multiplanar reconstruction in traumatic carpaldislocation orfracture-dislocation. Methods The clinical and imaging data of 48 cases confirmed of carpal dislocation or fracture-dislocationwere retrospective analyzed.The diagnostic accuracy of plain film radiography, CT (axial, MPR and VRreconstructionincluded) in the diagnosis of wrist dislocation were compared. Results In 48 patients diagnosed by clinical data,accuracy of spiral CT was 100% and accuracy of plain film radiography was 70.83%. There was significant difference ofcarpaldis location detection between CT and X-ray (χ2=4.5, P<0.05). Ten cases were unable to detect the small fractures ofscaphoid and triquetrum in the X-ray missed cases. Four cases were misdiagnosed in plain film which pisiform was the mostcommon. Conclusion Small carpal fractures may be missed even in a high detection rate of carpal dislocation in X-ray. MPRand VR reconstruction of spiral CT can clearly show carpal dislocation and fracture, provide imaging supports for clinicaltreatment. In addition, misdiagnosis of dislocation of some carpal in the plain film are caused by the passive position ofpatients.