数字化双能量减影对肋骨骨折的诊断价值  

Value of Dual-energy Subtraction with Direct Digital Radiography for Diagnosis Rib Fracture

作　　者：王秀河[1] 余深平[2] 陈立鹏 徐小玲[1] 王永安[1] 

机构地区：[1]暨南大学附属第一医院医学影像中心,广东广州510630 [2]中山大学附属第一医院放射科,广东广州510080

出　　处：《中山大学学报（医学科学版）》2011年第2期269-273,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省医学科学技术研究基金(A2009369)

摘　　要：【目的】探讨数字化双能量减影(DES)摄片技术在肋骨骨折诊断中的优势。【方法】收集在我院行双能量胸部摄影,经CT检查或随诊复查胸片证实为肋骨骨折的58个患者以及证实无肋骨骨折的29个患者的资料,由2位高年资放射科医师对其标准数字化摄影(DR)图像与双能量数字减影(DES)骨组织图像采用双盲法进行分析,评价两者对肋骨骨折的显示情况。【结果】DES骨组织图像与标准胸片对肋骨骨折总检出率差别没有统计学差异,但对于特殊部位(腋段、膈下肋骨),DES骨组织图像对肋骨骨折的显示要明显优于标准胸片。不同形态骨折的检出情况是不同的,对于完全性骨折,骨组织减影图像和标准DR图像的检出率分别是93.9%和84.1%,差异有统计学意义;对于不完全骨折,两者的检出率没有统计学差异。在伴有胸部合并伤的病例中,两种图像对肋骨骨折的检查阳性率没有统计学差异。【结论】双能量减影摄片技术能将骨与软组织单独分开显示,分别得出标准影像、软组织影像和骨组织影像,有效地去除软组织影的遮挡影响,可以较清晰显示骨折线及骨形态的改变,提高肋骨骨折的诊断率,降低漏诊率,是对标准DR图像诊断肋骨骨折的有效补充。[Objective] To evaluate the ability of dual-energy subtraction（DES） with direct digital radiography（DR） for diagnosis rib fracture.[Methods] To collect the data of 87 patients who had undergone dual-energy subtraction radiography and considered with their clinical data,58 of them have rib fracture that is confirmed by CT or rechecking;and 29 cases did not have any rib fracture.Two senior radiologists evaluate the standard DR images and the DES images by double blind method,and tell the situation of rib fracture.[Results] There is no prominent difference between the DES bone images and the standard DR images,but DES bone images could detect more rib fracture in same special location（armpit section and under diaphragm）.The detection of different forms of fracture is different,for the complete fracture,the detection rate of fracture for the DES images and standard DR images was 93.9% and 84.1%,the difference was statistically significant.For incomplete fracture,the detection rate of fracture between the two did not differ significantly.Surprisingly,the positive rate of cases with associated chest injury is similar in these images.[Conclusion] Dual-energy subtraction radiography technique can separate the bone and soft tissue,and the standard images,soft tissue and bone tissue images are obtained.Dual-energy subtraction technique can eliminate the influence of soft tissue effectually,then get a pure bone tissue image,which is superior to the standard DR images on detecting rib fracture.It can show fracture line and bone change more clearly.Dual-energy subtraction images can act as an effective complement for the standard DR images.

关 键 词：肋骨骨折 双能量减影 骨组织图像 

分 类 号：R814.42[医药卫生—影像医学与核医学]