多影像检查方法防止隐匿肋骨骨折漏诊的探讨

Exploration of multi-imaging method in prevention of missed diagnosis of occult rib fracture

目的探讨运用多种影像检查防止无明显移位肋骨骨折及肋软骨骨折的漏诊方法。方法回顾分析2009～2011年43例漏诊的无明显移位肋骨骨折及肋软骨骨折的X线片,结合临床及影像检查过程,对比单一胸片检查与多影像检查在隐匿肋骨骨折中准确性的区别。结果常规胸部正斜位片对43例无明显移位肋骨骨折及肋软骨骨折漏诊比例大,通过动态透视点片、延期复查、CT检查及超声多种影像检查方法提高了准确性。结论通过运用多种影像检查方法及多体位检查可防止无明显移位肋骨骨折及肋软骨骨折之类隐匿骨折的漏诊,减少不必要的纠纷。

Objective To explore the application of the multi-imaging method in the prevention of missed diagnosis of oc- cuh rib fracture and costochondral fracture. Methods The X-ray images of 43 cases of missed diagnosis of occult rib frac- ture and costochondral fracture from 2009 to 2011 were analyzed retrospectively. The difference in diagnosis accuracy be- tween single imaging and multi-imaging examination were compared combing the clinical examination process and the im- age examination process. Results Conventional thoracic original oblique imaging showed larger proportion of missed diagno- sis in the diagnosis of 43 cases of occult rib fracture and costochondral fracture. Dynamic perspective point-chip, delaying reexamination, CT examination and ultrasound multi-imaging improved the accuracy. Conclusion Muhi-imging and muhi- position examination can prevent the missed diagnosis of occult rib fractures such as rib fracture with no obvious displace- ment and costochondral fracture and therefore reduce unnecessary disputes.