目的 探讨CT平扫联合三维重建对不同下颌髁突骨折类型、骨骼移位类型和软组织损伤的诊断效能。方法 选择2017年6月至2022年6月于邢台市人民医院收治的80例疑似下颌髁突骨折患者，其中男性40例，女性40例;年龄22～65岁，平均年龄35。54岁;损伤原因，意外摔伤23例，交通事故致伤35例，打击致伤22例。全部患者均完善CT联合三维重建和MRI检查。以术中诊断作为评定金标准，比较两种检查方法对不同下颌髁突骨折类型、骨骼移位类型和软组织损伤的检出率，并采用受试者工作特性(ROC)曲线分析两种检查方法的诊断效能。结果 CT平扫联合三维重建和MRI检查对髁突头骨折、髁突颈部骨折、髁突下骨折和Ⅰ型、Ⅱ型、Ⅲ型骨折及关节腔积液的检出率对比，差异均无统计学意义(均P＞0。05)。MRI对韧带撕裂和髁突表面软组织损伤的检出率明显高于CT平扫联合三维重建[81。25％ vs 56。25％、78。75％ vs 52。50％。均P＜0。05]。ROC曲线结果显示，MRI和CT平扫联合三维重建对髁突骨折类型、关节腔积液和髁突骨折移位情况的诊断效能相当，差异无统计学意义(P＞0。05)。其中MRI对韧带撕裂和髁突表面软组织损伤的诊断效能优于CT平扫联合三维重建。结论 CT平扫联合三维重建和MRI检查对髁突骨折类型、骨折移位情况和关节腔积液的诊断效能相当，其中MRI对软组织损伤的诊断价值更高。
Efficacy analysis of plain CT scan combined with three-dimensional reconstruction in diagnosis of different types of mandibular condylar fracture,bone displacement and soft tissue injury
Objective To explore the diagnostic efficacy of plain CT scan combined with three-dimensional reconstruction in different types of mandibular condylar fracture,bone displacement and soft tissue injury.Methods From June 2017 to June 2022,a total of 80 patients with suspected mandibular condylar fracture were enrolled,which included 40 males and 40 fe-males,aged 22-65 years old with mean age of 35.54 years old.There were 23 cases of accidental fall injury,35 of traffic ac-cident injury and 22 of strike injury.All the patients were examined by CT combined with three-dimensional reconstruction and MRI.The intraoperative diagnosis was used as the gold standard for evaluation,the detection rates of different mandibular condylar fracture types,bone displacement types and soft tissue injuries were compared between the two examinations,and the receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of 2 examinations.Results There was no significant difference in detection rate of condylar anterior fracture,condylar neck fracture,subcondylar fracture,and type Ⅰ,type Ⅱ,type Ⅲ fracture,and joint effusion between CT plain scan combined with three-dimensional reconstruction and MRI(P＞0.05).The detection rate of ligament tear and condylar surface soft tissue injury by MRI was significantly higher than that by CT plain scan combined with three-dimensional reconstruction[81.25％ vs 56.25％,78.75％ vs 52.50％.P＜0.05].The ROC curve results showed that the diagnostic efficacy of MRI and CT plain scan combined with three-dimensional reconstruction in the diagnosis of condylar fracture type,joint cavity effusion and condylar fracture displacement was similar,and the difference was no statistically significant(P＞0.05),of which,MRI was superior to CT plain scan combined with three-dimensional reconstruction in diagnosis of ligament tear and condylar surface soft tissue injury.Conclusion It is demonstrated that CT plain scan combined with three-dimensional reconstruction and MRI detection have same diagnostic efficacy for condylar fracture type,fracture dis-placement and joint effusion,of which MRI with higher diagnostic value for soft tissue injury.
plain CT scanthree-dimensional reconstructionmandibular condylar fracturetype of bone shiftsoft tissue injuryperformance analysis
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