鼻部外伤DR与64层螺旋CT的诊断效果比较

Diagnostic Efficiency of DR and 64-slice Spiral CT in Nasal Trauma

目的比较DR与64层螺旋CT在鼻部外伤中的诊断效果。方法回顾性分析77例鼻部外伤患者1-7d内鼻骨侧位DR和头部64层螺旋CT检查的图像资料,比较DR和三维薄层CT显示鼻骨及其周围结构骨折的优缺点。结果 77例鼻部外伤患者中,CT诊断鼻骨线性骨折38例,粉碎性骨折31例,正常8例,合并邻近周围部位骨折25例。DR诊断骨折44例,疑似骨折14例,未见骨折19例(包括漏诊13例和正常6例),未见邻近周围部位骨折。CT诊断鼻骨骨折的正确率是100%,DR诊断鼻骨骨折的正确率和漏诊率分别为63.8%和18.8%,CT和DR两种诊断方式的诊断正确率之间有显著性差异(P<0.05)。结论 DR诊断鼻部外伤效果不佳,而64层螺旋CT能正确判断鼻骨有无骨折、骨折部位、类型及是否合并邻近周围部位骨折,建议将多层螺旋CT作为鼻部外伤诊断的首选检查方法。

Objective To explore the diagnostic efifciency of DR and 64-slice spiral CT in nasal bone fracture.Methods Nasal DR and 64-slice spiral CT data of 77 patients with nasal trauma within 1-7d after trauma were analyzed and compared. Results Of 77 patients with CT diagnosis, 38 patients were diagnosed as line-like fractures of nasal bone, 31 patients as comminuted fractures, 8 patients as normal, and 25 patients had concurrent fracture of the other adjacent sites. Of 77 patients with DR diagnosis, 44 patients were diagnosed as fractures of nasal bone, 14 patients as suspected fractures, 19 patients has no fracture （including missed fracture of nasal bone in 13 patients and normal nasal bone in 6 patients）, and no patient as concurrent fracture of the other adjacent sites. The correct rate of CT diagnosis of nasal bone fracture was 100%, however the correct rate and missed rate of DR diagnosis of nasal bone fracture were 63.8% and 18.8% respectively. The diagnotic correct rate between CT and DR was signiifcantly different （P〈0.05）.Conclusion 64-slice spiral CT can correctly judge the existence of nasal bone fracture, and the site and type of the fracture. Multi-slice spiral CT could be preferred as conventional method for the diagnosis of nasal trauma under possible medical conditions.