16层螺旋CT三维重建与DR平片检查对外伤性肋骨骨折的诊断价值比较研究

Comparative Study of Three-dimensional Reconstruction of 16-slice Spiral CT and DR Plain Film Examination in the Diagnosis of Traumatic Rib Fracture

目的:研究16层螺旋电子计算机断层扫描(CT)三维重建与数字化摄影(DR)平片检查对外伤性肋骨骨折的诊断价值,为临床诊治提供参考。方法:将2017年6月至2018年6月期间于本院接受诊治的82例外伤性肋骨骨折患者作为研究对象,所有患者均接受16层螺旋CT三维重建与DR平片检查,观察并记录患者的骨折发生部位,并比较两种诊断方法对外伤性肋骨骨折诊断的准确率、灵敏度、特异性、阳性预测值、阴性预测值以及漏诊情况。结果:82例外伤性肋骨骨折患者经影像学与临床诊断明确发生骨折179处,多发性骨折发生率为62.20%,单发性骨折发生率为37.80%,骨折肋骨段位中4-10段骨折发生率最高为69.83%,骨折肋骨水平阶段中腋肋骨折发生率最高为59.78%。相较于DR平片,16层螺旋CT三维重建诊断外伤性肋骨骨折的准确率、灵敏度、特异性、阳性预测值、阴性预测值更高,漏诊率更低,差异有统计学意义(P<0.05)。结论:相较于DR平片检查,应用16层螺旋CT三维重建检查外伤性肋骨骨折能明显提高临床诊断的准确率、灵敏度和特异性,减少漏诊,可为临床诊治提供更可靠的信息,值得临床推广。

Objective: To study the diagnostic value of 16-slice spiral computed tomography(CT) three-dimensional reconstruction and digital radiography(DR) plain film in traumatic rib fracture, and provide reference for clinical diagnosis and treatment.Methods: 82 cases of patients with traumatic rib fractures who were treated in our hospital from June 2017 to June 2018 were selected as subjects. All patients underwent three-dimensional reconstruction of 16-slice spiral CT and DR plain film examination. The fracture site of the patient was observed and recorded. The traumatic rib fracture of diagnostic accuracy rate, sensitivity, specificity, positive predictive value, negative predictive value and missed diagnosis of the two diagnostic methods were compared. Results: 82 cases of traumatic rib fracture were diagnosed by imaging and clinical diagnosis occurred 179 fractures. The incidence of multiple fractures was 62.20%,the incidence of single fracture was 37.80%. The highest incidence of 4-10 places was 69.83% in fractured rib segments. The highest incidence of axillary ribs fracture was 59.78% in the horizontal stage of fractured ribs. Compared with DR plain film, the traumatic rib fracture of diagnostic accuracy rate, sensitivity, specificity, positive predictive value and negative predictive value of three-dimensional reconstruction of 16-slice spiral CT were higher, missed diagnosis rate was lower. The difference was statistically significant(P<0.05).Conclusion: Compared with DR plain film examination, the accuracy rate, sensitivity and specificity of clinical diagnosis of traumatic rib fracture can be significantly improved by using three-dimensional reconstruction of 16-slice spiral CT. The missed diagnosis is reduced.It can provide more reliable information for clinical diagnosis and treatment, which is worthy of clinical promotion.