多层螺旋CT容积再现及曲面重建诊断肋骨及肋软骨轻微骨折的临床价值

Multilayer spiral CT volumetric representation and surface reconstruction diagnosis frame and the clinical value of rib cartilage minor fractures

目的 探讨多层螺旋CT(MSCT)容积再现(VR),曲面重建(CPR)检查在诊断肋骨及肋软骨轻微骨折中的临床价值.方法 回顾性分析112例临床疑似肋骨及肋软骨轻微骨折的X线片、轴位CT、VR、CPR影像学表现.对比四种检查方法诊断肋骨及肋软骨轻微骨折的灵敏性、特异性、阳性率、准确性、阴性率、漏诊率、误诊率及诊断价值.结果 VR、CPR检查可以清晰地显示肋骨及肋软骨轻微骨折,VR及CPR诊断的灵敏度(94.25％、98.85％)、特异性(88.00％、96.00％)、阳性率(96.47％、98.85％)、准确性(92.85％、98.21％)均高于X线、轴位CT检查(82.14％与88.51％,80.00％与84.00％,94.50％与96.25％,82.14％与87.50％),且CPR检查的诊断价值明显高于X线片、轴位CT、VR检查(曲线下面积:0.974与0.814、0.863、0.911),差异有统计学意义(P均＜0.01).结论 MSCT的VR及CPR检查在诊断肋骨及肋软骨轻微骨折中具有非常重要的临床应用价值.

Objective To explore the multislice CT (MSCT) volumetric representation (VR), curved surface reconstruction (CPR) in diagnosis of ribs and rib cartilage of the clinical value of minor fractures.Methods The X-ray films,axial CT,VR,CPR image performance of 112 cases of clinical suspected ribs and costal cartilage minor fractures were retrospective analyzed.The sensitivity, specificity, positive rate and accuracy,negative rate,missed diagnosis and misdiagnosis rate and the diagnostic value in the diagnosis of rib and rib cartilage minor fractures of four examination method were compared and analyzed.Results VR, CPR examination can clearly display the ribs and rib cartilage minor fractures, the diagnostic sensitivity (94.25％, 98.85％), specificity (88.00％, 96.00％), positive rate (96.47％, 98.85 ％) and accuracy (92.85％, 98.21％) of VR and CPR were higher than X-ray and axial CT examination(82.14％ and 88.51％ ,80.00％ and 84.00％, 94.50％ and 96.25％,82.14％ and 87.50％).And the diagnostic value of CPR inspection(the area under the curve) was 0.974, obviously higher than that of X ray film, axial CT, VR, and the difference was statistically significant (0.814,0.863,0.911;P＜0.05).Conclusion MSCT of VR and CPR examination in the diagnosis of rib in minor fractures and rib cartilage has very important clinical value.