MSCT Three-dimensional Reconstruction,Magnetic Resonance Imaging Characteristics and Combined Diagnostic Value of Occult Fracture in the Foot and Ankle in the Elderly

ZHU Jiang; XIN Yuqiang; LIU Yingjie; SHI Yunli; LI Shuo

doi:10.3969/j.issn.1002-3429.2024.08.014

Abstract：Objective To study the diagnostic value of multi-slice spiral CT(MSCT)three-dimensional reconstruc-tion,magnetic resonance imaging(MRI)and combined examination in elderly patients with occult fracture of the foot and an-kle joint,in order to provide reference for early clinical diagnosis.Methods A total of 120 elderly patients with suspected occult fracture of the foot and ankle joint admitted from March 2021 to January 2024 were selected as the research subjects.MSCT and MRI examination were performed after admission,to analyze the characteristics of MSCT three-dimensional recon-struction and MRI in elderly patients with occult fracture of the foot and ankle joint.The display rate of MSCT three-dimensional reconstruction and MRI in elderly patients with occult fracture of the foot and ankle joint,as well as the applica-tion value of MSCT three-dimensional reconstruction,MRI and combined examination in the diagnosis of occult fracture of the foot and ankle joint in the elderly,was compared.Results Of 120 elderly patients with suspected occult fracture of the foot and ankle joint,101 patients were finally diagnosed,and routine X-ray examination was negative.Among them,there were 33(32.67%)patientswithavulsionfracturesoftheexternalankle,26(25.74%)withanterolateralborderfracturesofcalca-neus,19(18.81%)withtalusfractures,8(7.92%)withmedialmalleolarfractures,6(5.94%)withposteriormalleo-lar fractures,5(4.95%)with distal tibiofibular fractures,2(1.98%)with cuboid fractures,1(0.99%)with proximal metatarsal fracture and 1(0.99%)with calcaneus fracture.The MSCT three-dimensional reconstruction was characterized by fracture of trabecular bone,loss of cortical bone continuity,and a certain degree of tear and loss of bone fragments.MRI showed irregular bone marrow lamina signal,irregular thin line and cord low signal on T1WI,slightly high or low signal on T2WI,and high or mixed high signal on fat inhibition sequence.MRI showed a higher display rate of bone contusion/bone marrow edema than MSCT three-dimensional reconstruction(P＜0.05).MSCT three-dimensional reconstruction,MRI and combined examination detected 97,95 and 101 elderly patients with occult fracture of the foot and ankle joint,respectively.The sensitivity of 100.00%(101/101)and accuracy of 100.00%(120/120)of combined examination were higher than those of MSCT 3D reconstruction[94.06%(95/101),93.33%(112/120)]and MRI[93.07%(94/101),93.33%(112/120)],and the missed diagnosis rate of 0 was lower than that of MSCT3D reconstruction[5.94%(6/101)]and MRI[6.93%(7/101)](P＜0.05).Conclusion The combined examination of MRI and MSCT three-dimensional reconstruc-tion can effectively improve the diagnostic accuracy of occult fracture of the foot and ankle fracture in the elderly,and can be used for early diagnosis and subsequent treatment.