MSCT薄层图像在隐匿性肋骨骨折中的诊断价值  

The diagnostic value of thin-slice imagines of MSCT in occult rib fracture

作　　者：刘成磊[1] 孙志先[1] 孙毅[1] 张毅[1] 刘婕[1] 

机构地区：[1]连云港市第二人民医院放射科,江苏省222023

出　　处：《中华临床医师杂志（电子版）》2014年第13期79-82,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：连云港市卫生局科研课题计划(1318)

摘　　要：目的：探讨MSCT薄层图像及冠状位重建在隐匿性肋骨骨折的诊断价值。方法回顾性分析45例钝性外伤患者肋骨骨折X线阴性的CT薄层图像及冠状位重建，记录肋骨骨折的部位、形态、数目；所有患者均于2-4周复查，并以患者的随访图像为诊断肋骨骨折的标准，比较MSCT薄层图像、薄层联合冠状位重建在隐匿性肋骨骨折中的诊断准确性。结果 CT随访图像确诊肋骨骨折63根，其中薄层图像检出57根，薄层图像联合冠状位重建检出63根，两者对比有统计学意义（χ^2＝2.04，P＝0.031）。骨折位于前弓31根，腋部17根，后肋15根。肋骨完全骨折25根；肋骨不完全骨折38根（骨密度增高6根，骨皮质皱褶19根，骨皮质翘起13根）。X线阴性肋骨骨折主要发生在前弓，最主要的类型是骨皮质皱褶。结论 MSCT 薄层图像能很好地显示隐匿性骨折的类型、部位及数目，联合冠状位重建能提高肋骨骨折的诊断准确性。Objective To discuss the value of thin-slice imagines and coronal reconstruction of MSCT in the diagnosis of occult rib fracture.Methods45 cases with blunt trauma who had negative result of DR were retrospectively analyzed using thin-slice imagines and coronal reconstruction of MSCT and the numbers,shapes,locations of rib fracture were recorded. All of patients were reexamined using CT in 2-4 weeks. The results of following-up imagines of CT were served as standard to evaluate the diagnostic accuracy of rib fracture, two methods （thin slice imagines,thin slice imagines combining coronal reconstruction） were compared.ResultsSixty-three rib fractures were diagnosed by following-up imagines of CT, where fifty-seven were detected by thin-slice imagines, sixty-three were found by thin slice imagines combining coronal reconstruction.There was statistical difference in the diagnosis accuracy of rib fracture using two observed methods （χ^2=2.04,P=0.031）. 31,17,15 of rib fractures were located in anterior arch,middle rib,posterior rib; 25 roots were complete fractures, 38 roots were incomplete fractures （6 roots show increased bone density,19 roots show buckled fracture,13 roots show bone cortex tilt）. The location of occult rib fractures were involved in anterior arch, the shape of occult rib fractures were buckled fracture.ConclusionThe locations,shapes,numbers of occult rib fractures can display on thin-slice imagines of MSCT, thin-slice imagines combining coronal reconstruction can improve the diagnostic accuracy of occult rib fracture.

关 键 词：肋骨骨折 体层摄影术 X线计算机 放射摄影术 

分 类 号：R683[医药卫生—骨科学]