多层螺旋CT三维技术与X线数字断层融合技术在肋骨骨折诊断中的价值比较

Comparison on Diagnostic Value of Multi-slice Spiral CT Three-dimensional Technique and X-ray Digital Tomosynthesis in Rib Fracture

目的比较多层螺旋CT(MSCT)三维技术与X线数字断层融合(DTS)技术在肋骨骨折诊断中的应用价值。方法选择我院2017年1月至2019年7月期间收治的100例胸部外伤怀疑肋骨骨折患者,均于我院行MSCT三维技术与DTS技术检查,影像图像清晰。结果经临床、手术及影像学证实100例患者共有212处肋骨骨折,其中多发性骨折(65.09%)多于单发(34.91%),4~7肋骨折最多(80.66%),腋肋最易发生骨折(52.83%);MSCT三维技术检出98例202处肋骨骨折,DTS技术检出92例188处肋骨骨折,MSCT三维技术诊断准确率显著高于DTS技术,差异有统计学意义(P<0.05);MSCT三维技术漏诊2例4处肋骨骨折,其中靠近肋软骨3例(75.00%),靠近胸椎1处(25.00%);DTS技术漏诊8例14处肋骨骨折,其中靠近肋软骨8例(57.14%),肋弓部、肋骨腋段、膈下肋骨各2处(14.29%);MSCT三维技术对肋骨骨折漏诊率著低于DTS技术,差异有统计学意义(P<0.05)。结论 DTS技术对肋骨骨折的诊断准确率不及MSCT三维技术,但其具有检查方便、费用低、辐射剂量小等优势,具推广价值,而MSCT三维技术应在特殊需求时使用。

Objective To compare the application value of multi-slice spiral CT(MSCT)three-dimensional technique and X-ray digital tomosynthesis(DTS)in diagnosising rib fractures.Methods 100 chest trauma patients suspected with rib fractures admitted to the hospital from January 2017 to July 2019 were enrolled.All underwent MSCT three-dimensional technique and DTS examination in the hospital.The images were clear.Results In 100 patients,there were 212 rib fractures confirmed by clinic,surgery,and imaging.Among them,multiple fracture was more than single fracture(65.09%vs.34.91%).4-7 rib fracture was the most(80.66%).Axillary rib was the most prone to fracture(52.83%).MSCT three-dimensional technique detected out there were 202 rib fractures in 98 cases,while 188 rib fractures in 92 cases detected out by DTS technique.The diagnostic accuracy of MSCT three-dimensional technique was significantly higher than that of DTS technique(P<0.05).There were 4 rib fractures in 2 cases missed by MSCT three-dimensional technique,including 3 cases(75.00%)near costal cartilage,and 1 case(25.00%)near thoracic vertebrae.There were 14 rib fractures in 8 cases missed by DTS technique,including 8 cases(57.14%)near costal cartilage,2 cases(14.29%)respectively at rib arch site,rib axillary segment,and subphrenic ribs.The missed diagnosis rate of MSCT three-dimensional technique was lower than that of DTS technique for rib fractures(P<0.05).Conclusion Although diagnostic accuracy of DTS technique is not as good as MSCT three-dimensional technique for rib fracture,it is accompanied with advantages such as convenient inspection,low cost,and small radiation dose.It has promotion value.MSCT three-dimensional technique should be applied in special needs.