CT在诊断胸骨粉碎性骨折中应用

The Application of CT in the Diagnosis of Sternum Comminuted Fractures

目的研究多层螺旋CT轴面与平面重组(MPR)表现在诊断胸骨粉碎性骨折中的应用。方法选取我院2011年3月至201 3年3月26例胸骨粉碎性骨折患者为研究对象,所有患者均经病理学诊断证实。26例患者均行16层螺旋CT胸部扫描,比较轴位图像与MPR图像上胸骨粉碎性骨折的检出率及合并其他胸部创伤的种类。结果MPR图像对胸骨粉碎性骨折检出率100%高于常规轴位CT84.62%,差异有统计学意义(P<0.05)。发现患者并发胸腔积液18例,胸骨后纵隔血肿10例,胸骨后纵隔气肿7例,肺挫伤15例,多发肋骨骨折16例。其中常规轴位CT检查出胸骨后纵隔血肿6例,漏诊4例;其余并发胸部创伤均检查出。MPR图像对胸骨粉碎性骨折患者胸部创伤的检出率均为100%。结论多层螺旋CT的MPR图像对胸骨粉碎性骨折的检出率较高,还可准确判断患者合并的胸部创伤,对患者选择适当的治疗方案及预后有重要意义。

Objective To study the application of axial multi-slice spiral CT and multiple planar reconstruction （MPR） in the diagnosis of stemmn comminuted fractures. Methods Twenty-six patients with stemmn comminuted fractures who were treated in our hospital between March 2011 and March 2013 were selected as study subjects. All patients were confirmed by pathological diagnosis. All subjects underwent 16 slice spiral CT chest scan. The detection rates of sternum comminuted fractures and types of other chest trauma were compared between the axial images and MPR images. Results The detection rate of MPR images in sternum comminuted fractures （100%） was higher than that of routine axial CT （84.62%） （P〈0.05）. There was pleural effusion in 18 cases, substernal nlediastinal hematoma in 10 cases, retrosternal mediastinal emphysema in 7 cases, pulmonary contusion in 15 cases, and multiple rib fractures in 16 cases. Among them, posterior mediastinal hematoma in 6 cases was detected by routine axial CT, and 4 cases were missed diagnosed; The rest cases with chest trauma were all detected. The detection rate of chest traunla in patients with sternum comminuted fractures by MPR images was 100%. Conclusion Not only the detection rate of CT images is higher than that of MPR. in the detection of sternunl comminuted fractures but also it can accurately determine the patient＇s chest trauma, which is of important significance in choosing the appropriate treatment plan and prognosis.