螺旋CT在肋骨隐匿性骨折患者中的诊断价值分析  

Diagnostic Value of Spiral CT in Patients with Occult Rib Fractures

作　　者：颜景华 殷亮 YAN Jinghua;YIN Liang(Department of Imaging,Department of Imaging Weifang Fangzi District People’s Hospital,Weifang 261000,China;Department of CT Room,Weifang Fangzi District People’s Hospital,Weifang 261000,China)

机构地区：[1]山东省潍坊市坊子区人民医院影像科,山东潍坊261000 [2]潍坊市坊子区人民医院CT室,山东潍坊261000

出　　处：《中国伤残医学》2024年第24期105-108,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨肋骨隐匿性骨折患者应用螺旋计算机断层扫描(CT)进行诊断的价值。方法:回顾性分析2023年7月—2024年6月山东省潍坊市坊子区人民医院收治的110例疑似肋骨隐匿性骨折患者资料,患者均进行DR检查、CT检查。将手术诊断结果作为肋骨隐匿性骨折的诊断金标准,比较DR检查、螺旋CT检查对肋骨隐匿性骨折的诊断效能,比较不同检查方法对肋骨骨折位置、伴胸腔内脏器损伤的诊断符合率。结果:螺旋CT检查的灵敏度、特异度、准确率、阳性和阴性的预测值分别为96.30%、100.00%、97.27%、100.00%、90.63%,均高于DR检查的86.42%、82.76%、85.45%、93.33%、68.57%,差异均有统计学意义(P<0.05)。DR检查结果与金标准具有中度一致性,螺旋CT检查结果与金标准具有高度一致。螺旋CT对前段和腋段肋骨骨折的诊断符合率为97.50%、98.55%,均高于DR检查的82.50%、88.41%,差异均有统计学意义(P<0.05);螺旋CT对于背段骨折的诊断符合率为96.88%虽然高于DR检查的87.50%,但差异无统计学意义(P>0.05)。螺旋CT检查对脾破裂、肝挫伤、肺挫伤的诊断符合率为96.77%、100.00%、100.00%,均高于DR检查的77.42%、84.62%、73.68%,差异均有统计学意义(P<0.05)。结论:临床诊断肋骨隐匿性骨折时采用螺旋CT检查的诊断效能高,不仅能准确诊断不同部位的肋骨隐匿性骨折,还能辅助评估胸腔内脏器损伤情况。Objective:To evaluate the diagnostic value of spiral computed tomography(CT)in the diagnosis of occult rib fractures.Methods:The data of 110 patients with suspected occulted rib fracture admitted to Weifang Fangzi District People’s Hospital from July 2023 to June 2024 were retrospectively analyzed,and DR And CT examination were performed.The results of surgical diagnosis were used as the gold standard for the diagnosis of rib occult fracture.The diagnostic efficiency of DR And spiral CT were compared,and the diagnostic coincidence rate of different methods for rib fracture location and intrathoracic organ injury was compared.Results:The sensitivity,specificity,accuracy,positive and negative predictive values of spiral CT were 96.30%,100.00%,97.27%,100.00%and 90.63%,respectively,which were higher than 86.42%,82.76%,85.45%,93.33%and 68.57%of DR,the differences were statistically significant(P<0.05).The results of DR Examination were moderately consistent with the gold standard,and the results of spiral CT examination were highly consistent with the gold standard,the diagnostic coincidence rates of spiral CT for anterior and axillary rib fractures were 97.50%and 98.55%,both higher than 82.50%and 88.41%of DR Examination,with statistical significance(P<0.05).The diagnostic coincidence rate of spiral CT was 96.88%higher than 87.50%of DR,but the difference was not statistically significant(P>0.05).The diagnostic coincidence rates of spiral CT for spleen rupture,liver contusion and lung contusion were 96.77%,100.00%and 100.00%,which were higher than 77.42%,84.62%and 73.68%for DR Examination,and the differences were statistically significant(P<0.05).Conclusion:The use of spiral CT in the clinical diagnosis of rib occult fractures is highly effective,which can not only accurately diagnose different parts of rib occult fractures,but also assist in the evaluation of intrathoracic organ injury.

关 键 词：肋骨隐匿性骨折 诊断 数字化X线摄影 螺旋计算机断层扫描 

分 类 号：R445.1[医药卫生—影像医学与核医学]