多层螺旋CT多平面重建技术在创伤性肋骨骨折患者诊断中应用价值探析  

Analysis of the application value of multi slice spiral CT multi plane reconstruction technology in the diagnosis of traumatic rib fracture patients

作　　者：王瑶 Wang Yao(Department of Imaging,Fuzhou First People′s Hospital,Jiangxi 344000,China)

机构地区：[1]江西省抚州市第一人民医院影像科,344000

出　　处：《实用医学影像杂志》2024年第2期140-143,共4页Journal of Practical Medical Imaging

摘　　要：目的 探讨多层螺旋CT(MSCT)多平面重建技术在创伤性肋骨骨折临床诊断中的应用价值。方法 选取2017年3月至2022年3月我院收治的80例疑似创伤性肋骨骨折患者作为研究对象,均行数字化X线摄影(DR)、MSCT检测,统计不同检查方式检出创伤性肋骨骨折情况,并以临床综合诊断为金标准,分析DR、MSCT诊断创伤性肋骨骨折的灵敏度、特异度、准确度、阳性预测值、阴性预测值;采用Kappa检验验证DR、MSCT诊断创伤性肋骨骨折与临床综合诊断的一致性,并分析创伤性骨肋骨骨折患者影像学检查特征。结果 80例疑似患者经临床综合诊断出69例创伤性肋骨骨折;DR检出63例,检出率为91%;MSCT检出68例,检出率为99%;MSCT诊断创伤性肋骨骨折的灵敏度、准确度高于DR,差异有统计学意义(P<0.05);Kappa检验显示,DR检查与临床综合诊断一致性尚可(Kappa值=0.57,P<0.001);MSCT检查与临床综合诊断一致性极好(Kappa值=0.85,P<0.001);在DR检查过程中部分患者胸部正位片、斜位图像肋骨重叠无法判断是否发生骨折;MSCT在检查过程中肋骨断端错位明显,重建图像中,清晰可见患者肋骨多发肋骨骨折部位、数量、形态及移位方向。结论 MSCT多平面重建技术在创伤性肋骨骨折诊断中具有较高价值,可准确鉴别骨折病情,为临床治疗方案制定提供重要参考。Objective To explore the application value of multi slice spiral CT(MSCT)multiplanar reconstruction technology in the clinical diagnosis of traumatic rib fractures.Methods Eighty patients with suspected traumatic rib fractures admitted to our hospital from March 2017 to March 2022 were selected as the research subjects.All patients underwent digital X-ray photography(DR)and MSCT testing,and different examination methods were used to detect traumatic rib fractures.Clinical comprehensive diagnosis was used as the gold standard to analyze the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of DR and MSCT in diagnosing traumatic rib fractures;use Kappa test to verify the consistency between DR and MSCT diagnosis of traumatic rib fractures and clinical comprehensive diagnosis,and analyze the imaging features of patients with traumatic rib fractures.The results showed that 69 of the 80 suspected patients were diagnosed with traumatic rib fractures through clinical comprehensive diagnosis;63 cases of DR were detected,with a detection rate of 91%;MSCT detected 68 cases,with a detection rate of 99%;The sensitivity and accuracy of MSCT in diagnosing traumatic rib fractures were higher than those of DR,and the difference was statistically significant(P<0.05);Kappa test showed that the consistency between DR examination and clinical comprehensive diagnosis was still acceptable(Kappa value=0.57,P<0.001);The consistency between MSCT examination and clinical comprehensive diagnosis is excellent(Kappa value=0.85,P<0.001);During the DR examination,some patients cannot determine whether a fracture has occurred due to overlapping ribs in the chest X-ray and oblique images;During the examination process of MSCT,there was significant dislocation of the fractured ends of the ribs.In the reconstructed image,the location,quantity,shape,and displacement direction of multiple rib fractures in the patient′s ribs can be clearly seen.Conclusion MSCT multiplanar reconstruction technology has high val

关 键 词：肋骨骨折 创伤性 体层摄影术 螺旋计算机 数字化X线摄影 诊断 

分 类 号：R683[医药卫生—骨科学] R816.8[医药卫生—外科学]