双能量CT骨髓分析技术鉴别不同时期肋骨骨折  

Dual-energy CT bone marrow analysis technology for distinguishing different stages of rib fracture

作　　者：杨斐[1] 姚永杰 王田祥 李杰 厉帆[1] YANG Fei;YAO Yongjie;WANG Tianxiang;LI Jie;LI Fan(Department of CT Room,Rizhao Traditional Chinese Medicine Hospital,Rizhao 276800,China;Department of Medical Imaging,People's Hospital of Rizhao Lanshan,Rizhao 276800,China)

机构地区：[1]日照市中医医院CT室,山东日照276800 [2]日照市岚山区人民医院影像科,山东日照276800

出　　处：《中国医学影像技术》2024年第12期1847-1850,共4页Chinese Journal of Medical Imaging Technology

基　　金：山东省医药卫生科技发展计划(202109011115)。

摘　　要：目的观察双能量CT骨髓分析技术鉴别不同时期肋骨骨折的价值。方法回顾性收集60例接受双能量CT扫描的肋骨骨折患者共273支受累肋骨;根据骨折时期将其分为血肿炎症机化期组(n=166)、纤维性骨痂期组(n=35)及硬骨痂-塑形期组(n=72)。分别基于原始CT及虚拟去钙颜色编码图计算骨折标准化CT值增量1及2,比较3组间及两两差异,评估其鉴别不同时期肋骨骨折的价值。结果3组间标准化CT值增量1及2差异均有统计学意义(P均<0.05);其中,标准化CT值增量1在纤维性骨痂期组与硬骨痂-塑形期组差异有统计学意义(P<0.05),标准化CT值增量2在两两组间差异均有统计学意义(P均<0.05)。以标准化CT值增量1=81.575 HU为截断值鉴别纤维性骨痂期与硬骨痂-塑形期的曲线下面积(AUC)为0.652;分别以标准化CT值增量2=55.700 HU、37.625 HU为截断值鉴别血肿炎症机化期与纤维性骨痂期、纤维性骨痂期与硬骨痂-塑形期肋骨骨折的AUC分别为0.668及0.905。结论基于双能量CT骨髓分析技术所获标准化CT值增量有助于鉴别不同时期肋骨骨折,尤其纤维性骨痂期与硬骨痂-塑形期。Objective To observe the value of dual-energy CT bone marrow analysis technology for distinguishing different stages of rib fracture.Methods Totally 273 ribs with fractures in 60 patients who underwent dual-energy CT scanning were retrospectively enrolled and divided into hematoma inflammation stage group(n=166),fibrous callus stage group(n=35)and bony callus-plastic stage group(n=72)according to the stage of rib fracture.The increment 1 and 2 of standardized CT value were calculated based on original CT images and virtual noncalcium color coded maps,respectively,and then were compared among 3 groups and between each 2 groups,and their values for distinguishing different stages of rib fracture were analyzed.Results Significant differences of increment 1 and 2 of standardized CT value were found among 3 groups(both P<0.05).Increment 1 of standardized CT values were significantly different between fibrous callus stage group and bony callus-plastic stage group(P<0.05),while increment 2 of standardized CT values were significantly different between each 2 groups(all P<0.05).Taken 81.575 HU as the cutoff value,the area under the curve(AUC)of increment 1 of standardized CT value for distinguishing fibrous callus stage and bony callus-plastic stage rib fracture was 0.652.Taken 55.700 and 37.625 HU as the cutoff values,AUC of increment 2 of standardized CT value for distinguishing hematoma inflammation stage and fibrous callus stage rib fracture,and fibrous callus stage and bony callus-plastic stage rib fracture was 0.668 and 0.905,respectively.Conclusion Increment of standardized CT value based on dual-energy CT bone marrow analysis technology was helpful for distinguishing different stages of rib fracture,especially fibrous callus stage and bony callus-plastic stage rib fracture.

关 键 词：肋骨 骨折 骨 体层摄影术 X线计算机 

分 类 号：R683.1[医药卫生—骨科学] R814.42[医药卫生—外科学]