64层螺旋CT后处理技术对不确定性肋骨骨折的诊断价值

The diagnostic value of post-processing technique of 64-slice spiral CT in uncertain rib fracture

目的探讨64层螺旋CT后处理技术对不确定性肋骨骨折的诊断价值。方法回顾分析64层螺旋CT容积扫描胸部外伤患者386例,筛选出26例患者,共32处不确定性肋骨骨折,将原始图像导入工作站进行多种后处理,包括薄层多平面重组、薄层曲面重组、表面遮盖、容积再现,进行诊断分析。结果薄层曲面重组发现肋骨骨折30处,排除2处,薄层多平面重组发现肋骨骨折30处,排除2处,表面遮盖发现骨折16处,容积再现发现骨折23处。表面遮盖、容积再现在显示骨折的空间解剖结构上有优势,薄层多平面重组、薄层曲面重组在显示肋骨骨折微细的变化上效果良好。结论薄层多平面重组、薄层曲面重组对不确定性肋骨骨折的显示较表面遮盖和容积再现图像更明确。薄层多平面重组、薄层曲面重组结合表面遮盖、容积再现三维重组图像对不确定性肋骨骨折的具体部位能准确定位。

Objective To explore the practical value of post-processing techniques of 64-slice spiral CT in diagnosis of uncertain rib fracture. Methods The CT appearances of 386 patients with chest trauma were retrospectively analyzed. Thirty-two uncertain rib fractures of 26 patients were examined by 64-slice spiral CT scan..All the original images were transferred to workstation to be post-processed to obtain thiwsection multi-planar reformation （TSMPR）, thin-section curved planar reformation （TSCPR）, surface shaded display （SSD）, and volume rendering （VR） images for analysis. Re- suits Thirty rib fractures were found by TSCPR, and 2 cases were excluded~ 30 rib fractures were found by TSMPR, and 2 cases were excluded~ 16 rib fractures were found by SSD~ and 23 rib fractures were found by VR. SSD and VR did well in displaying the anatomic structure of the fractures. TSMPR and TSCPR play an important role in demonstrating the details of rib fractures. Conclusion Comparing with SSD and VR, TSMPR and TSCPR are more accurate and comprehen- sive in diagnosis of uncertain rib fracture. TSMPR and TSCPR combined with SSD and VR can position specific parts of uncertain rib fractures correctly.