多层螺旋CT在肋骨病变中的应用:横断、MPR与VR图像的比较  

MSCT evaluation of costal bone lesions:comparison of axial,MPR and VR images

作　　者：沈峰[1] 钱雪荣[2] 谢国华[1] 张传臣[1] 狄玉进[1] 

机构地区：[1]山东省聊城市人民医院影像科,山东聊城252000 [2]山东省安康医院放射科,山东济宁272100

出　　处：《医学影像学杂志》2008年第9期1021-1024,共4页Journal of Medical Imaging

摘　　要：目的:比较常规横断面、MPR及VR在评价肋骨病变方面的准确性。方法:回顾性分析进行CT检查的41例肋骨病变患者,所有图像由三位放射医师阅片评价病变的性质(骨折、肿瘤及肿瘤样变、感染)。骨折的影像诊断包括骨折累及的肋骨位置及数目;肿瘤及肿瘤样病变的影像诊断必须说明病理学类型。最终诊断以活检及手术结果为标准。评价各种图像模式诊断的准确性及观察者间的一致性。结果:对于骨折,横断面图像诊断的符合率77%,MPR 100%,VR100%;对于肿瘤及肿瘤样病变,横断面诊断符合率为90%,MPR 96%,VR 99%;感染性病变,横断面诊断符合率为100%、MPR 100%、VR 100%。各观察者之间及对各类图像诊断的把握性无差异(P>0.05)。结论:评价感染性病变,横断面、MPR及VR图像之间无差异;对于骨折,肿瘤及肿瘤样病变,MPR及VR图像优于横断位图像。Objectlve：The aim of our study was to compare accuracies of axial, multiplanar, and volume-rendered 3D images in the diagnosis of costal bone lesions. Methods： Forty-one patients, aged from 10 years to 72 years old, with costal bone lesions underwent MDCT using axial, mulfiplanar, and 3D-volume-rendered imaging. All images were reviewed by three radiologists for the property of the lesions （fracture, tumor and tumor-like lesions or inflammation）. In case of fracture, the diagnosis was demonstrated with the location of the fracture and the amounts of the costal bone involved. In ease of a tumor or of tumor-like lesions, the diagnosis was demonstrated pathologieal property. Final diagnosis was determined by biopsy or surgery. Diagnostic accuracy, and inter observer agreement were evaluated. Results： For the diagnosis of fractures, average accuracy （average of the three observers for a true diagnosis） was 77% for axial, 100% for mLdtiplanar, and 100% for 3D-volume-rendered images. For the diagnosis of tumor and tumor-like lesions, average accuracy was 90% for axial, 96% for multiplanar, and 99% for 3D-volume-rendered images. For the diagnosis of inflammation lesions, average accuracy was 100% for axial, 100% for multiplanar, and 100% for 3D-volume-rendered images. There were no significant statistical differences in diagnostic performances, agreement with truth, or confidence scores among observers or imaging formats （ P 〉 0.05）. Conclusion：Axial, multiplanar, and 3D-volume-rendered images serve equally well as methods for assessing inflammation lesions. For evaluation of fracture, tumor and tumor-like lesions, maltiplanar and 3D-volume-rendered images perform better than axial images.

关 键 词：肋骨病变 体层摄影术 X线计算机 多平面重组 

分 类 号：R814.42[医药卫生—影像医学与核医学] R653.1[医药卫生—放射医学]