体表定位联合螺旋CT后处理技术在隐匿性肋骨骨折中的应用  

Application of body surface localization combined with post-processing techniques of spiral CTin thediagnosis of occult rib fracture

作　　者：祝永刚 高升 ZHU Yong-gang(Mongolian medicine and traditional Chinese Medicine hospital of Hohhot Municipality,Hohhot,Nei Monggol,010020,China)

机构地区：[1]呼和浩特市蒙医中医医院,内蒙古呼和浩特010020

出　　处：《齐齐哈尔医学院学报》2020年第22期2800-2802,共3页Journal of Qiqihar Medical University

摘　　要：目的评价体表定位联合螺旋CT图像后处理技术在肋骨隐匿性骨折中的应用价值.方法回顾性分析2017年1月—2019年12月本院收治的60例胸部外伤X线检查阴性,并2周内行肋骨CT扫描及三维重建的患者临床资料.CT扫描前根据患者压痛点进行体表定位,CT常规轴位扫描后先行薄层重建(标准算法SS30),再行重点观察区域曲面重建(CPR)、多平面重建(MPR)等后处理重建,分析体表定位联合螺旋CT图像后处理技术诊断隐匿性骨折的能力.结果60例患者2周内复查CT,发现52例患者112根肋骨隐匿性骨折,发现率86.7%,其中前肋骨折36根,占32.1%,侧肋54根,占48.2%,后肋22根,占19.6%;还有2例患者4周后仍有胸部疼痛,复查CT发现3处隐匿性骨折,漏诊率3.3%.结论螺旋CT骨算法重建、曲面重建、多平面重建技术对肋骨隐匿性骨折具有重要的应用价值,同时联合体表定位、局部重点观察,有助于骨折可疑点的精确定位,提高影像诊断医师的工作效率,提高骨折检出率,在临床上能够推广应用.Objective To investigate the application value of body surface localization combined with spiral CT image post-processing technology in the diagnosis of occult rib fracture.Methods The clinical data of 60 cases of patients with thoracic trauma those admitted to our hospital from January 2017 to December 2019 were collected,the patients with negative resultsof the chest X-ray examination and received rib CT scan and threedimensional reconstruction in our hospital within 2 weeks.The body surface localization was used before CT scan according to the pressure pain point.The image was reconstructed with thin layer after CT scan(Standard algorithmSS30).Then curved planar reformation(CPR),multi-planar reconstruction(MPR)and other postprocessing techniques were taken.To analyse the ability of surface localization combined with spiral CT image post-processing technique to diagnose occult fractureResults 112 occultfractures of ribs were found in 52 of all the 60 patients,with the discovery rate of 86.7%.Among them,36 fractures of the anterior rib,account for 32.1%,54 fractures of the lateral rib,account for 48.2%,22 fractures of the posterior rib,account for 19.6%.There were still 2 patients with chest pain after 4 weeks,and 3 hidden fractures were found by reexamination of CT,with the missed diagnosis rate of 3.3%.Conclusions Spiral CT bone algorithm reconstruction,CPR and MPR technology have important application value for occult rib fractures.At the same time,the combination of body surface localization and local key observation is helpful to the accurate location of suspected fractures,improve the work efficiency of radiologists,improve the detection rate of fractures,and could be widely used in clinical practice.

关 键 词：螺旋CT 体表定位 后处理技术 隐匿性肋骨骨折 

分 类 号：R445.3[医药卫生—影像医学与核医学]