DR片与多层螺旋CT三维重建技术在肋骨隐匿性骨折诊断中的应用

Application of DR Film and Multi-slice Spiral CT Three-dimensional Reconstruction Technique in The Diagnosis of Rib Occult Fractures

目的探究数字X线成像(DR)与多层螺旋CT(MSCT)三维重建技术在肋骨隐匿性骨折诊断中的应用价值。方法以2020年1月~2022年12月77例疑似肋骨骨折患者为研究对象,均给予DR片及MSCT三维重建技术检查[容积再现(VR)、曲面重建(CPR)、多平面重建(MRP)、最大密度投影(MIP)],比较DR片及MSCT三维重建技术检查对肋骨隐匿性骨折的诊断价值,及对不同类型肋骨隐匿性骨折的检出率。结果根据手术结果可知77例患者中存在肋骨隐匿性骨折59例,骨折部位共78处。MSCT检查结果与手术结果的一致性(Kappa=0.889)高于DR检查(Kappa=0.415)。MSCT诊断肋骨隐匿性骨折的AUC值大于DR(P<0.05)。MSCT三维重建技术中CPR检查结果与手术结果的一致性(Kappa=0.889)高于VR、MRP、MIP检查(Kappa=0.372、0.782、0.231)。MSCT三维重建技术中CPR、MRP诊断肋骨隐匿性骨折的AUC值大于VR、MIP(P<0.05)。MSCT中CPR、MRP技术对内缘皮质骨折的检出率高于DR及MSCT中VR、MIP技术,且外缘皮质骨折的检出率高于MSCT中MIP技术(P<0.05)。结论相比于DR,MSCT三维重建技术对肋骨隐匿性骨折具较高的诊断价值,且MSCT中CPR、MRP技术对不同类型骨折的检出率均较高。

Objective To explore the application value of digital radiography(DR)and multi-slice spiral CT(MSCT)threedimensional reconstruction technique in the diagnosis of rib occult fractures.Methods 77 patients with suspected rib fractures from January 2020 to December 2022 were selected as the study subjects,and all patients underwent DR film and MSCT three-dimensional reconstruction technique[volume reconstruction(VR),curve planar reconstruction(CPR),multiplanar reconstruction(MRP),maximum intensity projection(MIP)].The diagnostic value of DR film and MSCT three-dimensional reconstruction technique on rib occult fractures and the detection rates of different types of rib occult fractures were compared.Results According to the surgical result,there were 59 cases of rib occult fractures among 77 patients,with 78 fracture sites.The consistency of MSCT result with surgical result(Kappa=0.889)was higher than that of DR result(Kappa=0.415).The AU C of MSCT in the diagnosis of rib occult fractures was higher than that of DR(P<0.05).Among MSCT three-dimensional reconstruction,the consistency of CPR with surgical result(Kappa=0.889)was higher than that of VR,MRP and MIP(Kappa=0.372,0.782,0.231).The AUC of CPR and MRP in the diagnosis of rib occult fractures was higher than that of VR and MIP(P<0.05).The detection rate of internal cortical fracture by CPR and MRP in MSCT was higher than that by DR and that by VR and MIP in MSCT,and the detection rate of external cortical fracture was higher than that by MIP in MSCT(P<0.05).Conclusion Compared with DR,MSCT three-dimensional reconstruction has high diagnostic value on rib occult fractures,and the detection rates of CPR and MRP in MSCT are higher for different types of fractures.