MRI检查与不同体位MSCT 3D检查对复杂踝关节损伤、分型的诊断价值

doi:10.3969/j.issn.1671-7171.2025.06.013

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摘要【目的】探讨磁共振成像(MRI)检查与不同体位多层螺旋CT(MSCT)3D检查对复杂踝关节损伤及分型的诊断价值。【方法】回顾性分析2021年4月至2023年3月本院收治的215例复杂踝关节损伤患者的临床资料,所有患者均接受常规体位MSCT 3D检查、优化体位MSCT 3D检查及MRI检查。以病理诊断为金标准,分析MRI与不同体位MSCT 3D对复杂踝关节损伤、分型、软骨损伤类型及预后的诊断价值。【结果】215例复杂踝关节损伤中,旋前-外旋型(PE)46例、旋后-外旋型(SE)38例、旋后-内收型(SA)49例、垂直压缩型(VC)32例、旋前-外展型(PA)50例;Ⅰ期40例、Ⅱ期59例、Ⅲ期64例、Ⅳ期52例;解剖复位186例,非解剖复位29例。优化体位MSCT 3D诊断准确率和对VC诊断的准确率高于常规体位MSCT 3D、MRI(P<0.05),常规体位MSCT 3D诊断率高于MRI(P<0.05)。3种检查方法诊断复杂踝关节损伤分型中PE、SE、SA、PA的准确率比较,差异无统计学意义(P>0.05)。MRI诊断不同类型软骨损伤和复杂踝关节损伤解剖复位的准确率高于优化体位MSCT 3D、常规体位MSCT 3D(P<0.05),且优化体位诊断准确率高于常规体位(P<0.05)。【结论】优化体位MSCT 3D检查诊断复杂踝关节损伤、VC分型的价值高于MRI与常规体位MSCT 3D检查,MRI检查在诊断软骨损伤类型及预后中的价值高于不同体位下MSCT 3D检查。

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	赵宝琼
	韩超
	徐爱民
	王恬怡

关键词 ：踝损伤, 踝关节, 磁共振成像, 体层摄影术,螺旋计算机, 诊断

Abstract：【Objective】To investigate the diagnostic and prognostic value of magnetic resonance imaging (MRI) and multi-slice spiral CT (MSCT) 3D examination in different body positions in the diagnosis and classification of complex ankle joint injuries. 【Methods】The clinical data of 215 patients with complex ankle injuries admitted to the hospital from April 2021 to March 2023 were retrospectively analyzed. All patients received conventional position MSCT 3D examination, optimized position MSCT 3D examination and MRI examination. Taking pathological diagnosis as the gold standard, the diagnostic value of MRI and different body positions' MSCT 3D in complex ankle joint injury, classification, type of cartilage injury and prognosis were analyzed. 【Results】Of 215 cases of complex ankle injuries, 46 cases of pronation-pronation type (PE), 38 cases of supination-external pronation type (SE), 49 cases of supination-adduction type (SA), 32 cases of vertical compression type (VC), 50 cases of pronation-abduction type (PA). There were 40 cases of stage Ⅰ, 59 cases of stage Ⅱ, 64 cases of stage Ⅲ, and 52 cases of stage Ⅳ. Anatomical reduction occurred in 186 cases and non-anatomical reduction in 29 cases. The diagnostic accuracy of optimized postural MSCT 3D and VC was higher than that of conventional position MSCT 3D and MRI (P<0.05), and the diagnostic rate of MSCT 3D in conventional position was higher than that of MRI (P<0.05). There was no difference in the accuracy of PE, SE, SA and PA among the three methods in the diagnosis of complex ankle injury classification (P>0.05). The accuracy of MRI in diagnosing anatomic reduction of different types of cartilage injury and complex ankle injury was higher than that of MSCT 3D in optimal position and MSCT 3D in conventional position (P<0.05), and the diagnostic accuracy of MSCT 3D in optimal position was higher than that of conventional position (P<0.05). 【Conclusion】Optimized postural MSCT 3D examination is more valuable than MRI and conventional postural MSCT 3D examination in diagnosing complex ankle injuries. The value of MRI in the diagnosis of cartilage injury type and prognosis is higher than that of MSCT 3D in different positions.

Key words： Ankle Injuries Ankle Joint Magnetic Resonance Imaging Tomography, Spiral Computed Diagnosis

收稿日期: 2024-09-06

中图分类号:

R684.77

引用本文:

赵宝琼, 韩超, 徐爱民, 王恬怡. MRI检查与不同体位MSCT 3D检查对复杂踝关节损伤、分型的诊断价值[J]. 医学临床研究, 2025, 42(6): 955-958.
ZHAO Baoqiong, HAN Chao, XU Aimin, et al. Diagnostic Value of MRI and Different Postural MSCT 3D Imaging for Complex Ankle Joint Injury. JOURNAL OF CLINICAL RESEARCH, 2025, 42(6): 955-958.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.06.013 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I6/955

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