多层螺旋CT对隐匿性肋骨骨折的诊断价值  

Diagnostic Value of Multi-slice Spiral CT in Occult Rib Fracture

作　　者：陈小华 周伟 CHEN Xiaohua;ZHOU Wei(First People's Hospital of Fuzhou,Jiangxi Province,Fuzhou 344000,China;不详)

机构地区：[1]江西省抚州市第一人民医院,江西抚州344000

出　　处：《中国医学创新》2023年第12期129-132,共4页Medical Innovation of China

摘　　要：目的:探讨多层螺旋CT(MSCT)对隐匿性肋骨骨折(ORF)的诊断价值。方法:选取2019年1月-2022年1月抚州市第一人民医院收治的疑似ORF患者共计82例,均给予MSCT检查、X线片检查,以临床表现、随访等结果作为金标准,比较不同检查方法的诊断价值、不同重建技术的检出情况和不同诊断时间的骨折检出数量。结果:MSCT检查的敏感度、特异度、阳性预测值、阴性预测值分别为98.25%、100.00%、100.00%、96.15%,X线片检查分别为82.46%、68.00%、85.45%、62.96%,MSCT检查敏感度、特异度、阳性预测值、阴性预测值与X线片检查相比更高(P<0.05);容积再现(VR)、曲面重建(CPR)、最大密度投影(MIP)、多平面重组(MPR)的总检出率分别为77.32%、97.94%、26.80%、94.85%,VR、CPR、MPR检出率高于MIP(P<0.05);伤后11~20 d、41~50 d首次检查和复查的骨折检出数量比较差异均无统计学意义(P>0.05),伤后21~30 d、31~40 d复查的骨折检出数量与首次检查相比更多(P<0.05)。结论:MSCT对ORF有着较高的诊断价值,检查时宜采用MPR为主,VR定位,CPR重点观察的分析模式,伤后21~40 d是ORF进行复查的较佳时间段。Objective:To explore the diagnostic value of multi-slice spiral CT(MSCT)in occult rib fracture(ORF).Method:A total of 82 patients with suspected ORF who were admitted in First People's Hospital of Fuzhou from January 2019 to January 2022 were selected.All patients were examined by MSCT and X ray.With the clinical manifestations and follow-up results as the gold standard,the diagnostic value of different examination methods,the detection of different reconstruction techniques and the number of fractures detected at different diagnosis times were compared.Result:The sensitivity,specificity,positive predictive value,negative predictive value of MSCT were 98.25%,100.00%,100.00%,96.15%,respectively,and that of X-ray was 82.46%,68.00%,85.45%,62.96%,respectively.The sensitivity,specificity,positive predictive value,negative predictive value of MSCT were higher than those of X-ray(P<0.05).The total detection rates of volume rendering(VR),curved plannar reconstruction(CPR),maximum intensity projection(MIP),and multiplanar reconstruction(MPR)were 77.32%,97.94%,26.80%,and 94.85%,respectively,the total detection rate of VR,CPR,MPR was higher than that of MIP(P<0.05).There was no significant difference in the number of fractures detected in the first examination and reexamination 11-20 days and 41-50 days after injury(P>0.05),and the number of fractures detected in the reexamination 21-30 days and 31-40 days after injury were more than those in the first examination(P<0.05).Conclusion:MSCT has a high diagnostic value for ORF.MPR should be the main examination method,and VR for positioning and CPR for focus observation.

关 键 词：隐匿性肋骨骨折 多层螺旋CT 诊断价值 

分 类 号：R816.8[医药卫生—放射医学] R683.1[医药卫生—临床医学]