隐匿性肋骨骨折多层螺旋CT最佳检查时间段的研究

Research of the MSCT Optimal Examination Time for the Occult Rib Fracture

目的探寻隐匿性肋骨骨折（ORF）多层螺旋CT的最佳检查时间段,为法医鉴定伤情及临床诊治肋骨骨折提供准确依据。方法分析50例胸部外伤患者的影像资料,于伤后10天内行首次胸部多层螺旋CT检查,经薄层重建VR及MPR显示为ORF,并于伤后20-50天内复查多层螺旋CT,比较伤后不同检查时间诊断的隐匿性肋骨骨折数与首次检查诊断肋骨骨折数的差异。结果同一患者在不同的时间进行检查,被诊断ORF的数目往往不同,受伤后21-40天复查的结果与首次检查结果显示的ORF的数目差异具有统计学意义。结论伤后21-40天复查多层螺旋CT,根据骨痂的病理生理变化,能够比较准确、客观地显示ORF,21-40天为诊断ORF的最佳时间段。

Objective Explore the best period of MSCT examination time in the occult rib fracture to provide accurate evidence for forensic injury. Methods 50 cases of chest trauma from October 2014 to October 2015 were analyzed retrospectively,they were examined by chest MSCT in 10 days after trauma and diagnosed occult rib fracture by a thin layer of VR and MPR reconstruction,and then re-examined by chest MSCT in 20- 50 days. The number of ribs,which had been found to have occult fractures in the first examination,was compared to that in re-examinations. Results The number of occult rib fractures at different inspection times is often different. There was statistical significance between the number of rib fractures in 10 days and 21- 40 days after the injury. Conclusion MSCT could diagnose occult rib fracture more objectively according to pathophysiological changes of callus in the stage of 21- 40 days,which is optimal examination time for the occult rib fracture.