目的 探讨多层螺旋CT(MSCT)后处理技术及体检信息对肋骨骨折(RF)诊断的应用效果。方法 随机选取2019-01至2023-12武警山东总队医院收治的400例RF患者的MSCT资料,其中受伤7d内初检且受伤3~8周内复检的97例患者纳入本研究。初检分为A、B组,由2名影像科高年资医师独立诊断, A组医师了解患者体格检查信息后,对容积再现(VR) 、最大密度投影(MIP)、多平面重建(MPR) 、曲面重建(CPR)进行针对性诊断;B组医师对以上项目进行盲诊。以复检结果为标准,统计分析常规横断面(TRA)图像和后处理技术诊断各类型RF的效能。结果 初检时,A组不同方式诊断Ⅰ、Ⅱ、Ⅲ型RF的准确率均高于B组,其中Ⅰ、Ⅲ型RF的诊断准确率比较,差异有统计学意义(P<0.05),MPR、CPR方式诊断Ⅰ、Ⅲ型RF的准确率显著高于其他方式(P<0.05);不同方式诊断Ⅱ型RF的准确率差异均无统计学意义,但MPR后处理技术可视性强、诊断平均用时短于其他方式,差异有统计学意义(P<0.05);Ⅳ型RF在初检时未检出,88例均在复检时检出,其中MIP方式诊断准确率明显高于其他方式,差异有统计学意义(P<0.05)。结论 MSCT后处理技术可用于不同类型RF的诊断,不但诊断准确率高,且诊断用时较短,可明显提高诊断RF的效率。
Abstract
Objective To explore the application effect of multi-slice spiral CT(MSCT) post-processing technique and physical examination information in the diagnosis of rib fracture (RF). Methods MSCT data of 400 RF patients admitted to Shandong Provincial Corps Hospital of Chinese People's Armed Police Force from January 2019 to December 2023 were randomly selected, and 97 patients who were initially examined within 7 days of injury and re-examined within 3 to 8 weeks of injury were included in this study. The initial examination was divided into group A and Group B, which were independently diagnosed by two senior physicians in the imaging department. In Group A, the physician conducted targeted diagnosis after performing a physical examination; in Group B, the diagnosing physician performed blind diagnosis. Based on the reexamination results, the performance of conventional transverse (TRA) images and post-processing techniques in diagnosing various types of RF was analyzed statistically. Results At the initial examination, the diagnostic accuracy of type Ⅰ, Ⅱ and Ⅲ RF by different methods in group A was higher than that in group B, with statistical difference (P<0.05). The diagnostic accuracy of type Ⅰ and Ⅲ RF by MPR and CPR was significantly higher than that by other methods (P<0.05). The accuracy of diagnosis of RF type Ⅱ by different methods was not significantly different between and within groups, but the post-processing technology had strong visibility and the mean diagnostic time was short (P<0.05). Type Ⅳ RF was not detected at the initial examination, 88 cases were detected at the reexamination, and the diagnostic accuracy of MIP diagnosis was significantly high that of other methods, the difference was statistically significant (P<0.05). Conclusions MSCT post-processing technique can be used in the diagnosis of different types of RF, not only the diagnosis accuracy is high, but also the diagnosis time is short, which can significantly improve the diagnosis efficiency of RF.
关键词
肋骨骨折 /
后处理技术 /
X线计算机体层摄影术 /
诊断 /
伤残鉴定
Key words
rib fracture /
post-processing technique /
X-ray computed tomography /
diagnosis /
disability assessment
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