16层螺旋CT三维重建与DR平片对外伤性肋骨骨折的诊断探究

Clinical research on diagnosis of traumatic rib fractures by multislice CT VRT and DR plain film

目的：研究16层螺旋CT三维重建与DR平片对外伤性肋骨骨折的诊断价值。方法：对白求恩国际和平医院收治的72例外伤性肋骨骨折患者分别行16层螺旋cT三维重建及DR平片检查。统计患者骨折部位，比较两种检查方法肋骨骨折确诊率及骨折合并症检出情况。结果：肋骨骨折多发高于单发，且多发生于第4～10肋骨及腋段，16层螺旋CT三维重建对肋骨骨折诊断准确率为97．2％，DR平片诊断准确率为80．3％，16层螺旋CT三维重建诊断率明显高于DR（x2=19．15，P〈0．01）；DR平片漏诊的肋骨骨折主要位于肋软骨（占58．1％），16层螺旋CT三维重建发现其他部位骨折19处及肺部合并症16例。结论：16层螺旋CT薄层诊断肋骨骨折极大提高了诊断准确率，在隐匿性肋骨骨折及并发症方面其临床价值明显优于DR平片。

Objective： To research the value of diagnosis of traumatic rib fractures by multislice CT VRT and DR plain film. Methods： Seventy-two cases of traumatic rib fracture patients were diagnosed by DR film and multislice CT VRT. Results： Multiple rib fractures than single, most of them occurred in the 4-10 ribs and axillary segment, 97.2% of 16-slice spiral CT three- dimensional reconstruction of patients with rib fracture diagnosis rate significantly higher than DR plain film diagnosis rate 80.3% （x2=19.15, P〈0.01）, DR plain film missed rib fractures are mainly located in the costal cartilage （58.1%）, 16-slice spiral CT reconstruction is still found 19 other fractures and lung complications 16cases. Conclusion： 16-slice CT the thin layer VRT diagnosis of rib fractures greatly improves the diagnostic accuracy.