MSCT对外伤性肋骨骨折的诊断及固定术后复查的应用价值分析

Analysis on Application Value of MSCT in the Diagnosis of Traumatic Rib Fracture and in the Reexamination after Fixation

目的旨在探讨MSCT对外伤性肋骨骨折的诊断及固定术后复查的应用价值。方法选取我院2017年8月到2019年2月收治的56例外伤性肋骨骨折患者,患者均进行了MSCT检查及DR线检查,比较两种检查对肋骨骨折检出率,分析MSCT在外伤性肋骨骨折术前诊断、术后复查中的临床价值。结果本研究56例患者中,共79处肋骨出现骨折,大多发生于第4~10肋骨折、腋段。X线对外伤性肋骨骨折的检出率为81.01%(64/79),MSCT对外伤性肋骨骨折的检出率为98.73%(78/79),MSCT对外伤性肋骨骨折的检出率均明显高于X线,差异具有统计学意义(χ^(2)=13.630,P<0.001);X线诊断外伤性肋骨骨折时间为(23.36±7.13)min,明显高于MSCT[(14.31±5.02)min],差异具有统计学意义(t=9.224,P<0.001);X线检查中,存在一部分患者因投照角度未能完全观察骨折位置,如与肩胛骨投影位置相重叠,肋骨骨折的段位或错位现象不明显后行CT扫描。不完全性骨折表现为肋骨单侧皮质断裂、凹陷或者隆起。CT平扫可见肋骨多发骨折,部分肋骨断端错位明显,部分患者合并胸腔积液,三维重建中,MPR方便观察骨折的部位、数量、形态和移位方向、是否有骨痂形成。VR通过容积数据的较高级的重建方式可任意方位进行切割和旋转,较为满意地显示出骨折线、移位及肋软骨;手术后1~8天内均进行CT平扫复查,能明确显示、观察肋骨内固定物植入情况。结论MSCT可有效检出外伤性肋骨骨折,诊断用时短,在固定术后复查MSCT可多角度、多方位展现固定情况,为临床治疗提供可靠资料。

Objective To investigate the application value of MSCT in the diagnosis of traumatic rib fracture and the in reexamination after fixation.Methods 56 patients with traumatic rib fractures admitted to our hospital from August 2017 to February 2019 were enrolled.All patients underwent MSCT and X-ray examination.The two groups were compared for the detection rate of rib fractures.To analyze the clinical value of MSCT in preoperative diagnosis and postoperative reexamination of traumatic rib fractures.Results 79 ribs were fractured in 56 patients in this group,mostly in the 4th to 10th ribs and axilla.The detection rate of X-ray for traumatic rib fracture was 81.01%(64/79).The detection rate of MSCT for traumatic rib fracture was 98.73%(78/79).The detection rate of MSCT for traumatic rib fracture was significantly higher than that of X-ray,the difference was statistically significant(χ^(2)=13.630,P<0.001).The time of diagnosis for traumatic rib fracture by X-ray was(23.36±7.13)min,which was significantly higher than that of MSCT(14.31±5.02)min.The difference was statistically significant(t=9.224,P<0.001).In the X-ray examination,some patients did not completely observe the position of fracture due to the angle of projection,such as overlapping with the position of projection of the scapula,or for example,CT scan was performed after the segment or displacement of the rib fracture was not obvious.Incomplete fractures were characterized by unilateral cortical fractures,depressions or bulges in the ribs.CT scan showed multiple fractures of the ribs,and some ends of fractured bone can be shown with obvious displacement,and some patients were combined with pleural effusion.In 3D reconstruction,CPR was convenient for observing the location,number,shape and displacement direction of the fracture,and whether there was formation of callus.VR can cut and rotate in any direction through the higher-level reconstruction of volume data,which showed the fracture line,displacement and costal cartilage satisfactorily.CT scans were performed within 1 to 8 days after surgery,which can clearly show and observe the condition of fixation in ribs.Conclusion MSCT can effectively detect traumatic rib fractures,and the diagnosis time is short.In reexamination after fixation,MSCT can show the condition of fixation in multiple angles and multiple directions,which provides reliable information for clinical treatment.