应用64排螺旋CT多种后处理技术在肋骨骨折诊断中的临床价值分析

Clinical Value Analysis of 64-Slice Spiral CT Multiple Post-Processing Techniques in the Diagnosis of Rib Fractures

目的探讨应用64排螺旋CT多种后处理技术在肋骨骨折诊断中的临床价值。方法选取本院2016年6月~2018年6月就诊的疑似肋骨骨折60例胸部外伤患者。均行DR摄片,并行64排螺旋CT轴位检查、容积再现(VR)、多平面重建(MPR)等后处理技术检查,比较后处理技术方法对肋骨骨折、骨折数量尤其是隐匿性骨折检出情况。结果影像学检查及复查确诊肋骨骨折146处,CT轴位、CT后处理技术对肋骨骨折例数检出率分别为96.00%和98.00%,显著高于X线平片的80.00%,差异有统计学意义(P<0.05)。CT后处理技术对肋骨骨折数量检出率为99.32%,高于X线平片、CT轴位的69.18%和80.82%,差异有统计学意义(P<0.05)。漏诊情况:X线平片漏诊7例,36处,其中以肋软骨附近漏诊最多,占66.67%%;CT轴位漏诊2例、16处,分别是肋软骨附近4处,第1肋骨3处,腋段肋骨3处,膈下肋骨2处,前肋4处;CT后处理技术未漏诊,可疑骨折数1处。结论64排螺旋CT后处理技术对肋骨骨折以及骨折数量检出率高,能有效降低漏诊率,弥补X线平片、CT轴位存在的不足,减少不必要的医疗纠纷。

Objective To investigate the clinical value of 64-slice spiral CT in the diagnosis of rib fractures.Methods Sixty patients with suspected rib fractures from June 2016 to June 2019 were enrolled in this study.All patients underwent DR photography,parallel 64-slice spiral CT axial examination,volume rendering(VR),multiplanar Post-processing techniques such as reconstruction(MPR)were performed to compare the post-processing techniques for the comparison of rib fractures,fracture numbers,and especially occult fractures.Results Radiographic examination and retrospective examination confirmed 146 fractures of ribs.The detection rates of CT axial and CT post-treatment techniques for rib fractures were 96.00% and 98.00%,respectively,which was statistically different from the 80.00% of X-ray films,(P<0.05).The number of rib fractures detected by CT post-processing was 99.32%,which was higher than 69.18% and 80.82% of X-ray plain film and CT axial position(P<0.05).Missed diagnosis:X-ray plain film missed diagnosis in 7 cases,36 places,of which the most missed diagnosis was near costal cartilage,accounting for 66.67%%;CT axial position missed diagnosis in 2 cases,16 places,respectively,4 places near costal cartilage,3 places in the first rib,3 places in axillary segment rib,2 places under diaphragm rib,4 places in front rib;CT post-processing technology did not miss diagnosis,and the number of suspicious fractures was 1.Conclusion The 64-slice spiral CT post-processing technique has a high detection rate of rib fractures and fractures,which can effectively reduce the rate of missed diagnosis,make up for the deficiency of X-ray film and CT axial position,and reduce unnecessary medical disputes.