多层螺旋CT及其后处理技术对隐匿性骨折的诊断价值

The diagnostic value of multislice spiral computed tomography(MSCT) post-processing techniques for occult fracture

目的探讨多层螺旋CT(MSCT)及其后处理技术对隐匿性骨折的诊断价值。方法选择2010年12月～2011年12月在我院收治的48例外伤患者,首先经X线平片(CR、DR)检查作为A组,A组检查结果为阴性但通过临床体征或随访怀疑有急性外伤的患者,进行MSCT扫描后,通过特殊的CT图像处理软件在工作站处理后,得到高清晰度的二维重建MPR和MIP图像以及三维SSD和VRT图像,经放射科有经验的医师共同阅片,以确诊是否有骨折现象作为B组,比较两组诊断结果。结果 A组显示10例有骨折现象,阳性率20.8%(10/48);B组42例显示有骨折,阳性率87.5%(42/48)。其中肋骨骨折6例,肩胛骨骨折4例,髋关节9例,膝关节12例,踝关节及足跗骨10例,股骨颈骨折5例,骨盆骨折2例;两组比较差异性显著(P<0.05)。结论 MSCT及其后处理技术对隐匿性骨折是一种有效的检测手段,对治疗方案的选择及预后的估计有重要价值。

Objective To discuss the diagnostic value of multislice spiral computed tomography（MSCT） and its post-processing technique of occult fracture.Methods 48 cases with trauma from December 2010 to December 2011 in our hospital were divided into two groups.Group A was examined by X-ray（CR,DR）;group B was the patients with negative results by X-ray,however,they had clinical signs or suspected for acute trauma,examined by MSCT scanning and deal with CT image processing software in the workstation processing,then obtained high-resolution two-dimensional reconstruction of MPR and MIP images or SSD and VRT images,after that they were read by physician in radiology department for the diagnosis of fracture phenomena.The diagnostic results were compared between the two groups.Results Group A showed 10 cases with fracture phenomena,the positive rate was 20.8%（10/48）;group B showed 42 cases with fracture,the positive rate was 87.5%（42/48）.6 cases were rib fractures,4 cases were scapula fracture,9 cases were hip fractures,12 cases were knee fractures,and 10 cases were ankle and foot tarsal fractures,5 cases were femoral neck fracture and 2 cases were pelvic fractures;the difference was significant（P〈0.05）.Conclusion MSCT and its post-processing technology for occult fractures is an effective detection,and it has important value for treatment options and prognosis estimated.