基于斜横断位重建的多层螺旋CT诊断不全性肋骨骨折层厚的研究

The layer thickness of oblique-axial reconstruction with multi-slice spiral CT in the diagnosis of incomplete rib fractures

目的探讨多层螺旋CT(MSCT)在诊断外伤性不全性肋骨骨折中斜横断位重建层厚的选择问题。方法选取100例经MSCT复查证实有不全性肋骨骨折患者的首次CT图像,在工作站上将首次CT图像行层厚/层间距为1/1、2/2、3/3、4/4及5/5 mm的斜横断位重建,以复查CT结果为标准,比较不同层厚诊断不全性肋骨骨折数的差异。结果100例患者复查CT共确诊不全性肋骨骨折474处,首次CT检查在层厚/层间距为1/1、2/2、3/3、4/4及5/5 mm斜横断位分别发现299、295、289、238及221处不全性肋骨骨折,诊断准确率分别为63.08%、62.24%、60.97%、50.21%、46.62%,1/1、2/2与3/3 mm之间比较差异无统计学意义(P>0.05),上述三种层厚与4/4、5/5 mm之间比较差异有统计学意义(P<0.05),4/4与5/5 mm比较差异无统计学意义(P>0.05)。结论层厚/层间距为3/3 mm的斜横断位重建既可以保证肋骨骨折的诊断准确率,又可以提高工作效率,可以推荐作为日常工作斜横断位重建的标准。

Objective To discuss the selection of layer thickness with oblique-axial reconstruction in the diagnosis of traumatic incomplete rib fractures by multi-slice spiral CT(MSCT).Methods The initial CT images of 100 patients with 474 rib fractures confirmed by MSCT rescanning were collected.In the initial CT images,299,295,289,238 and 221 incomplete rib fractures were found at oblique-axial panes with layer thickness/spacing of 1/1,2/2,3/3,4/4 and 5/5 mm respectively,and the results of rescanning CT were used as the standard to compare the differences in the number of incomplete rib fractures diagnosed by different thickness.Results A total of 100 patients with 474 incomplete rib fractures were confirmed by CT rescanning,the initial CT images with layer thickness/spacing of 1/1,2/2,3/3,4/4 and 5/5 mm at oblique-axial reconstruction found 299(63.08%),295(62.24%),289(60.97%),238(50.21%)and 221(46.62%)incomplete rib fractures,respectively.There was no significant difference between 1/1,2/2 and 3/3 mm(P>0.05),and compared with the above three kinds of thickness,there was significant difference between 4/4,5/5 mm(P<0.05).There was no significant difference between 4/4 and 5/5 mm(P>0.05).Conclusion The oblique-axial reconstruction with layer thickness/layer spacing of 3/3mm can not only ensure the diagnosis accuracy of rib fractures,but also improve the work efficiency.So it can be recommended as the standard for the oblique-axial reconstruction in daily work.