多排螺旋CT肋骨三维重建呼吸运动伪影与肋骨骨折鉴别诊断

Differential Diagnosis of Respiratory Motion Artifact and Rib Fracture in 3D Reconstruction of Multi-slice Spiral CT

目的:探讨64排螺旋CT肋骨三维重建检查中呼吸运动伪影产生的原因及表现。方法:对56例存在呼吸运动伪影的肋骨三维重建图像进行分析,运用三维重建技术容积重建(volume reconstruction,VR)、多平面重建(multiple plannar reconstruction,MPR)等分析呼吸运动伪影的表现。结果:56例患者中,肋骨三维重建检查共发现呼吸运动伪影的肋骨269处,肋骨骨折215处,VR和MPR上呼吸运动伪影都有特异的表现,VR图像上表现为平行于横断面的"骨折线",且大多有"错位"、边缘模糊;MPR上呼吸运动伪影表现为"断端"两侧的肋骨相互嵌插,并且断端骨皮质逐渐变薄,没有明确的断端。结论:呼吸运动伪影的产生是由于患者的精神紧张、呼吸急促等,三维重建可以鉴别呼吸运动伪影与肋骨骨折,对减少误诊具有重要的作用。

Objective To investigate the causes and manifestations of the respiratory motion artifacts in rib 3D reconstruction with 64-row spiral CT. Mothods Totally 56 patients with the respiratory motion artifacts had the rib 3D reconstruction images with VR and MPR. Results There were 269 artifacts and 215 rib fractures found, and specific manifestations for VR and MPR. VR showed some fracture line paralleling with the cross section, mostly accompanied by malposition or edge blurting. MPR found the rib at one broken end inserted into the one at the other end, and the cortical bone thinned gradually and had no clear broken ends. Conclusion The causes for respiratory motion artifact include mental stress, tachypnea and etc, and 3D reconstruction can be used for the differential diagnosis of the respiratory artifact and rib fracture in order to decrease misdiagnosis.