多排螺旋CT对隐匿性肋骨骨折的诊断价值及最佳复查时间研究

Diagnostic Value and Optimal Review Time of Multi-slice Spiral CT for Occult Rib Fracture

目的:探讨多排螺旋CT对隐匿性肋骨骨折的诊断价值及最佳复查时间。方法:选取2017年7月到2018年7月期间在我院接受治疗的胸部外伤患者95例,在首次检查时均接受了X线平片和多排螺旋CT检查,比较首次检查时X线平片和多排螺旋CT的检出率,比较首次检查时X线平片和多排螺旋CT对不同类型骨折的诊断情况,比较各个时间段复查病例的肋骨骨折数与首次检查时的差异。结果:95例患者中最终86例确诊存在肋骨骨折,首次检查时多排螺旋CT的检出率为95.35%(82/86),高于X线平片的82.56%(71/86)(P<0.05)。86例患者最终确定共存在骨折289处,首次检查时X线平片共检出246处,多排螺旋CT共检出274处,多排螺旋CT对线性骨折、凹陷性骨折的检出率高于X线平片(P<0.05)。伤后11-20d、伤后41-50d、伤后51-60d的复查肋骨骨折数与首次检查肋骨骨折数比较无统计学差异(P>0.05),伤后21-30d、伤后31-40d的复查肋骨骨折数高于首次检查肋骨骨折数(P<0.05)。结论:多排螺旋CT对隐匿性肋骨骨折有较高的诊断价值,首次诊断时的检出率明显高于X线平片,伤后21-40d这个时间段是进行复查的较佳时间段,可获得较好效果。

Objective: To investigate the diagnostic value and optimal review time of multi-slice spiral CT for occult rib fracture.Methods: 95 patients with chest trauma who were treated in our hospital from July 2017 to July 2018 were enrolled. All patients underwent X-ray and multi-slice spiral CT examinations during the first examination. The detection rates of X-ray plain and multi-slice spiral CT were compared between the first examination, and the diagnosis of different types of fractures by X-ray plain and multi-slice spiral CT was compared. The number of rib fractures in the reexamination cases at each time period was compared with that at the first examination. Results: The final 86 cases of rib fracture were confirmed in 95 patients. The detection rate of multi-slice spiral CT at the first examination was 95.35%(82/86), which was higher than that of X-ray plain film 82.56%(71/86)(P<0.05). A total of 289 fractures were identified in 86 patients. 246 fractures were detected by X-ray plain film, and 274 by multi-slice spiral CT. The detection rate of linear fracture and depressed fracture by multi-slice spiral CT was higher than that by X-ray plain film(P <0.05). The number of rib fractures examined 11-20 d after injury, 41-50 d after injury and 51-60 d after injury was compared with the number of rib fractures examined at the first time, there was no significant difference between the two groups(P>0.05). The number of rib fractures examined21-30 d after injury and 31-40 d after injury was higher than the number of rib fractures examined for the first time(P<0.05). Conclusion:Multi-slice spiral CT has a high diagnostic value for occult rib fracture. The detection rate at the first diagnosis is significantly higher than that of X-ray film. The time period from 21-40 d after injury is the best time to review, good results can be obtained.