DR胸部正斜位摄片与MSCT重建技术对肋骨骨折的急诊诊断价值对比

Diagnostic Value of DR Chest Positive Oblique Radiography and MSCT Reconstruction Technique for Rib Fracture

目的旨在探讨DR胸部正斜位摄片与MSCT重建技术对肋骨骨折的急诊诊断价值。方法选取我院2016年2月到2018年6月经急诊收治的肋骨骨折患者59例,患者入院均经急诊进行了DR及MSCT检查,对比DR及MSCT对肋骨骨折的检出率。结果59例患者共94处肋骨骨折,第1~3肋13处(13.82%),第4~5肋10处(10.63%),第6~7肋26处(27.65%),第8~9肋16处(17.02%),第10~12肋29处占比最高,为30.85%。DR对肋骨骨折诊断检出率、漏诊分别为71.27%、28.72%,MSCT重建技术对肋骨骨折的诊断检出率、漏诊率分别为98.93%、1.06%,MSCT重建技术对肋骨骨折的检出率、漏诊率均高于DR检查(χ^(2)=28.268,P<0.001);21例患者DR胸部正位片、斜位图像肋骨重叠无法判断是否发生骨折;CT平扫可见肋骨多发骨折,部分肋骨断端错位明显,重建图像中清晰可见患者肋骨多发肋骨骨折部位、数量、形态和移位方向。结论MSCT重建技术能有效检出肋骨骨折数目,立体显示骨折位置、移位、形态及移位状态等,可为临床提供更多可靠信息。

Objective To explore the emergency diagnostic value of DR chest positive oblique radiography and MSCT reconstruction technique for rib fracture.Methods 59 patients with rib fractures who were admitted to the emergency department in our hospital from February 2018 to June 2019 were enrolled.All patients underwent DR and MSCT exa minations,and the detection rates of DR and MSCT for rib fra ct u res we re compared.Results There were 94 rib fractures in 59 patients,13 fractures(13.82%)in the 1 st to 3 rd ribs,10 fractures(10.63%)in the 4 th to 5 th ribs,26 fractures(27.65%)in the 6 th to7 th ribs,and 16(17.02%)fractures in the 8 th to 9 th ribs.26 fractures in 10 th to 12 th ribs accounted for the highest proportion,30.85%.The diagnostic rate and missed diagnosis rate of rib fractures were 71.27%and 28.72%,respectively.The diagnostic rate and missed diagnosis rate of rib fractures by MSCT reconstruction technique were 98.93%and 1.06%,respectively.The detection rate and missed diagnosis rate of rib fractures by MSCT reconstruction technique were higher than those by DR examination(x~2=28.268,P<0.001).In 21 patients,the rib in the DR chest positron image and the oblique image overlapped,and it was impossible to judge whether fractu re occurred.CT scan showed multiple fractures of the ribs,and some of the rib fractures were dislocated.The reconstructed images clearly showed the location,number,shape,and displacement direction of the ribs.Conclusion The MSCT reconstru ction technique ca n effectively detect the number of rib fractures and stereoscopically display the position,displacement,shape,and state of displacement of the fracture,improving more reliable information in the clinic.