MSCT扫描和三维重建技术在降低隐匿性骨折漏诊率中的临床应用效果

Clinical Application Effect of MSCT Scanning and Three-dimensional Reconstruction Technology in Reducing the Missed Diagnosis Rate of Occult Fractures

目的:探讨多层螺旋CT(MSCT)扫描和三维重建技术在降低隐匿性骨折漏诊率中的临床应用效果。方法:选择2020年1月-2022年1月福州市第二医院收治的经过X线检查结果正常,但临床工作中高度怀疑具有隐匿性骨折的160例患者作为研究对象。全部患者接受MSCT扫描并利用三维重建技术进行医学影像学诊断。计算MSCT扫描和三维重建技术对隐匿性骨折的诊断效果。计算MSCT扫描中各项重建技术对隐匿性骨折的诊断准确率。结果:经过“金标准”诊断,160例患者中,共有156例发生隐匿性骨折,4例为阴性。MSCT扫描和三维重建技术的对于隐匿性骨折的诊断敏感度为96.15%(150/156),诊断特异度25.00%(1/4),诊断的准确率为94.38%(151/160),诊断的阳性预测值为98.04%(150/153),诊断的阴性预测值为14.29%(1/7)。胫骨平台及肱骨部位的隐匿性骨折分别出现了3例的漏诊情况,肋骨的隐匿性骨折出现了3例的误诊情况。容积再现法对隐匿性骨折的诊断准确率为84.38%,多平面重建(MPR)对隐匿性骨折的诊断准确率较高,为94.37%。结论:在隐匿性骨折患者的诊断过程中,采取MSCT扫描和三维重建技术的方法,可以有效地提升诊断效率,为患者的临床治疗方案制定提供数据支持,值得在临床工作中推广。

Objective:To investigate the clinical application effect of multi-slice spiral CT(MSCT)scanning and three-dimensional reconstruction technology in reducing the missed diagnosis rate of occult fractures.Method:A total of 160 patients with normal X-ray examination results but highly suspected occult fractures in clinical work admitted to Fuzhou Second Hospital from January 2020 to January 2022 were selected as the research objects.All patients underwent MSCT scanning and medical imaging diagnosis using three-dimensional reconstruction technology.The diagnostic effect of MSCT scanning and three-dimensional reconstruction technology on occult fracture were calculated.The diagnostic accuracy of various reconstruction techniques in MSCT scanning for occult fracture were calculated.Result:After the“gold standard”diagnosis,among the 160 patients,a total of 156 had occult fractures,and 4 cases were negative.The diagnostic sensitivity of MSCT scanning and three-dimensional reconstruction technology for occult fractures was 96.15%(150/156),the diagnostic specificity was 25.00%(1/4),the diagnostic accuracy was 94.38%(151/160),the positive predictive value of diagnosis was 98.04%(150/153),the negative predictive value of diagnosis was 14.29%(1/7).The occult fractures of the tibial plateau and humerus were missed in 3 cases respectively,and the occult fractures of the rib were misdiagnosed in 3 cases.The diagnostic accuracy of volume rendering method for occult fracture was 84.38%,and the diagnostic accuracy of multiplanar reconstruction(MPR)for occult fracture was higher,which was 94.37%.Conclusion:In the process of diagnosing patients with occult fractures,MSCT scanning and three-dimensional reconstruction technology can effectively improve the diagnostic efficiency and provide data support for the formulation of clinical treatment plans for patients,which is worth promoting in the clinical work.