影像科学与光化学

本研究探讨CT与磁共振成像(MRI)在踝关节运动骨折分型及诊断中的应用。选取184例(184踝)踝关节骨折患者进行临床研究，所有患者术前均接受CT、MRI检查，分析MRI踝关节骨折分型与骨折分度的关系，不同分型的踝关节骨折患者韧带损伤情况，根据患者手术后6个月的踝关节功能恢复情况将患者分为优良组(118例)和一般组(66例),对比两组患者手术后CT和MRI影像特征的差异。结果显示，骨折分度为Ⅰ度的患者主要骨折分型为旋后内收型，骨折分度为Ⅱ度的患者主要骨折分型为旋后外旋型，骨折分度为Ⅲ度的患者主要骨折分型为旋后外旋型、旋前外展型，骨折分度为Ⅳ度的患者主要骨折分型为旋前背屈型；CT、MRI诊断不同类型踝关节骨折分型的准确率均超过85%,两种方式诊断的准确率比较，差异无统计学意义(P>0.05);术后6个月，优良组患者外踝前后移位<2.0 mm、内踝前后重叠移位<2.0 mm、后踝移位值<2.0 mm的患者占比高于一般组(P<0.05)。CT、MRI在踝关节骨折术前分型诊断中均具有较高的实用价值，术后根据影像学参数可评估患者关节功能康复效果。

This study investigated the application of CT and magnetic resonance imaging(MRI) in the classification and diagnosis of ankle sports fractures. A total of 184 patients(184 ankles) with ankle joint injury were selected for clinical research. All patients received CT and MRI examinations before the operation. The relationship between MRI ankle fracture classification and fracture grade was analyzed. According to the patient's ankle function recovery 6 months after operation, the patients were divided into an excellent group of 118 cases and a general group of 66 cases, and the differences in CT, characteristics and MRI characteristics of the two groups of patients after operation were compared. The results showed that, the main fracture classification of patients with fracture grade Ⅰ was supination and adduction type. The main fracture classification of patients with fracture grade Ⅱ was supination and external rotation type. The main fracture types of patients with grade Ⅲ were supination and external rotation type, pronation and abduction type. The main fracture type of patients with fracture grade Ⅳ was pronation and dorsiflextion type. The correct rates of CT and MRI in diagnosing different types of ankle fracture were all over 85%, and there was no significant difference in the correct rates of the two methods(P>0.05).6months after operation,the proportion of patients with anterior and posterior displacement of the lateral malleolus <2.0 mm,overlapping anterior and posterior displacement of the medial malleolus<2.0mm,and posterior malleolus displacement value <2.0 mm in the excellent group was higher than that in the general group(P<0.05).Both CT and MRI have high practical value in the preoperative classification and diagnosis of ankle fractures,and postoperative joint function rehabilitation effects can be evaluated based on imaging parameters.