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目的探讨MSCT、MRI扫描对Schatzker IV型胫骨平台骨折患者膝关节的诊断价值以及关节面的塌陷、劈裂程度与半月板损伤之间的相关性。材料与方法回顾性分析45例Schatzker IV型胫骨平台骨折患者的临床及影像资料,对膝关节软性结构(含前、后交叉韧带及内侧半月板)的损伤情况进行评估,同时对内侧胫骨平台面的塌陷及劈裂程度与半月板损伤之间的相关性进行测量。结果以磁共振诊断结果作为参考标准,MSCT诊断前、后交叉韧带损伤的敏感性、特异性、阳性预测值、阴性预测值、准确率分别为72%,92%,65%,95%、90%。MRI发现半月板损伤患者共34例(约76%,34/45),其平均关节面塌陷程度为1.3 cm(0~2.3 cm),关节面劈裂距离为1.5 cm(0~2.9 cm);另11例没有半月板损伤的患者中,其平均关节面塌陷程度为0.5 cm(0~1.2 cm),关节面劈裂距离为0.4 cm(0~1.2 cm);这两组病例的两个测量参数之间的差异均有统计学意义(p=0.01)。结论 Schatzker IV型骨折合并较高的韧带及半月板撕裂,MSCT、MRI扫描对该型骨折的评估具有重要的临床应用价值。
Objective To investigate the diagnostic value of MSCT and MRI in the diagnosis of knee osteoarthritis of Schatzker type IV tibial plateau fractures and the correlation between the degree of collapsing and the degree of rupture of articular surface and meniscus injury. Materials and Methods The clinical and imaging data of 45 patients with Schatzker IV tibial plateau fractures were retrospectively reviewed. The soft tissue structures (including the anterior and posterior cruciate ligaments and the medial meniscus) of the knee were evaluated for their injuries. At the same time, the medial tibial plateau The correlation between the degree of collapse and cleavage of the face and the meniscus injury was measured. Results Based on the results of MR diagnosis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MSCT in diagnosis of posterior cruciate ligament injury were 72%, 92%, 65%, 95%, 90 %. MRI showed that there were 34 cases (about 76%, 34/45) in the meniscus injury. The average degree of articular collapse was 1.3 cm (0 ~ 2.3 cm) and the articular surface splitting distance was 1.5 cm (0 ~ 2.9 cm). In the other 11 patients without meniscus injury, the mean degree of articular collapse was 0.5 cm (0-1.2 cm) and articular surface cleavage distance was 0.4 cm (0-1.2 cm). The two measurements in these two groups The differences between the parameters were statistically significant (p = 0.01). Conclusion Schatzker type IV fractures are associated with high ligament and meniscus tear. MSCT and MRI scan have important clinical value in the evaluation of this type of fracture.