Application Of DR,MSCT And Post-processing Techniques In The Diagnosis Of Wrist And Wrist Interosseous Joint Injuries

Objective To study the imaging findings of the X-ray plain film,the CT axis examination and various post-processing reconstruction techniques of wrist joint injury,and to discuss their respective advantages,disadvantages and clinical application value to provide imaging basis for accurate diagnosis of complex wrist joint in clinic.Materials and MethodsCase data: From Feb 2016 to Jan 2019,all patients with carpal joint injury were reviewed and collected.Priority is given to patients with complex injuries,the imaging data of 150 patients with carpal joint injury in our hospital were collected.93 male wrist joints(age range of 18 to 59 years,mean age of 38.1 years)and 57 female wrist joints(age range of 19 to 58 years,mean age of 47.6 years)were collected.Scanning method:(1)DR plain film examination: The wrist joint of the patient's wound was positively photographed using a German Siemens DR camera.(2)CT examination: examination was performed using GE's Bright Speed 16-row-multi-slice CT scanner.Image processing:The CT scanning raw data is transmitted to the ADW4.6 workstation.The 1.25 mm slice thickness is used to reconstruct the original image by VR,MPR,MIP post-processing?Image analysis:Using the picture archiving and communicating system(PACS),two doctors used the blind method to evaluate and analyze the images.Comprehensive observation fracture dislocation,bone density-change,surrounding soft-tissue damage comparing the display of the same injury to the same patient by different examination methods.Record the results and the statistical analysis.Statistical methods:(1)The comparison of DR and the CT test,(2)The comparison of axial CT scan and MSCT test,(3)The comparison of MSCT test`s three post-processing reconstruction methods.Set the clinical discharge diagnosis of patients as a comparative reference.Statistical analysis of the data used SPSS 17.0 software.The chi-square test was used for the difference analysis.The p-values of the three groups of chi-square tests were all 0.05.When p?0.05,the difference was statistically significant.ResultThe total detection rate of CT was higher than that of DR.Except for complete fracture,the detection of avulsion fracture,occult fracture,dislocation,osteonecrosis,soft tissue swelling and joint space change were all significant(p < 0.05).The detection rate of reconstruction after MSCT spiral scan was better than that of CT axial scan.The fracture,dislocation,occult fracture,avulsion fracture,scaphoid separation and reconstruction of the navicular bone,the trapezium bone and the hamate bone were higher than those of conventional CT axial plain scan(p < 0.05).There was a significant difference between the two groups.There was a significant difference between the two groups.There was a significant difference between the two groups(p < 0.05).Three post-processing reconstruction methods for spiral CT scanning were compared.Except the trapezoid bone,the pisiform,and the base fracture of metacarpal bone,the three methods of injury were different.(1)Compared with VR,MPR was superior to VR,in the diagnosis of the lunate bone,the capitate bone,occult fracture and avulsion fracture.(2)Comparing MPR with MIP,MPR was superior to MIP,P < 0.05 in the diagnosis of the other 5 carpal fractures,as well as bone fragments,occult fractures and avulsion fractures.(3)VR and Compared with MIP,VR was superior to MIP,P < 0.05 in the diagnosis of the navicular bone,the triangular bone,the trapezium bone and bone fragments,and the difference was statistically significant.Comprehensive evaluation of MPR showed the highest.ConclusionComparing with routine X-ray examination,CT examination is recommended in early stage for patients suspected of multiple or multiple injuries or who are unable to determine the specific extent of wrist injuries.For patients suspected of dislocation,MSCT is recommended as a direct choice compared with axial CT scan confined to horizontal orientation.The display of VR and MIP should not be neglected except for MPR for the types of multiple injuries,especially those of distal ulnar and radius fractures,which affect the relative spatial relationship of wrist bones.