不同重建方法对多层螺旋CT诊断肋骨骨折准确性的影响

The influence on different reconstructions of multi-slice spiral CT in diagnosing rib fracture

目的探讨多层螺旋CT检查的不同重建方法在诊断肋骨骨折的价值。方法收集37例胸部外伤患者X线片疑有骨折的病例,进行多层螺旋CT检查及多种图像后处理,观察几种不同图像对骨折显示效果。结果X线检查共发现肋骨骨折48处,肋软骨骨折0处。通过多层螺旋CT扫描后进行图像后处理共检出肋骨骨折77处,肋软骨骨折4处。两种检查方法对于肋骨、肋软骨骨折的检出比较差异有统计学意义。(χ2=39.652,P=0.000;χ2=4.101,P=0.043)。多层螺旋CT检查,曲面MPR图像检出移位肋骨骨折39处,未移位肋骨骨折38处。VRT重建图像检出移位肋骨骨折38处,未移位肋骨骨折30处。两种重建方法对于未移位肋骨骨折的检出比较差异有统计学意义。(χ2=8.941,P=0.003)。结论多层螺旋CT的曲面MPR图像可清晰显示未移位细微骨折线,VRT重建图像立体感强,可多角度观察骨折的移位。多层螺旋CT检查对于判断肋骨,尤其是肋软骨骨折有很高的诊断价值,明显优于X线检查,应为诊断肋骨骨折的可靠依据。

Objective：To probe the role of post-imaging treatment of multi-lice spiral CT in diagnosing rib fracture. Methods： MSCT scanning and a variety of reconstructions of imagos were performed for 37 patients suspicious of rib fractures indicated by X-ray in order to bring out differencez in displaying the fracture. Results：48 points of fibs fracture and no costal cartilage fracture were found out with X- ray films. 77 points of ribs fracture and 4 points costal cartilage fracture were found out by MSCT. There has statistical difference between the two groups （X^2 = 39.652, P = 0.000; X^2 = 4. 101, P = 0.003）. 39 points dislocation ribs fracture and 38 points location ribs fracture were found out with curved MPR. 38 points dislocation ribs fracture and 30 points location ribs fracture were found out with VRT. There has statistical difference between the two groups （ X^2 = 8.941, P = 0.043 ）. Conclusion： The curved MPR was better in displaying location ribs fracture. VRT helps to observe fracture displacement and dislocation with multi-angle and multi-position. VRT and curved MPR of multi-slieespiral CT is very useful in the diagnosis of ribs fracture, especially in costal cartilage fracture. It exceeds X-ray examination. It may be considered as a dependable standard in the diagnosis of rib fracture.