潘金万+阙松林+李棠华+谢开琼

[摘要] 目的 分析多层螺旋CT三维重建技术（MSCT）在创伤性肋骨骨折诊断中诊断准确率和诊断用时方面的优越性。 方法 选择2016年3月～2017年3月期间来我院就诊的急诊外伤并初步诊断为肋骨骨折的患者106例为研究对象，所有患者均进行数字X线摄影和MSCT诊断，并结合手术病理诊断结果，比较两种诊断手段在肋骨骨折诊断中的检测准确率和诊断用时情况。 结果 MSCT肋骨骨折检出117处，检测准确率为98.32%，明显高于数字X线摄影技术的检测准确率68.91%，两者之间存在显著性差异（χ2=37.566，P=0.000<0.05）。多层螺旋CT扫描并经三维重建后处理技术诊断用时明显比数字X线摄影技术短，两组之间存在显著性差异（P<0.05）。 结论 MSCT诊断肋骨骨折其诊断准确性高，诊断用时短，适合临床进一步推广应用。

[关键词] 创伤性肋骨骨折；多层螺旋CT；三维重建技术；准确率；优越性

[中图分类号] R816.8；R683.1 [文献标识码] B [文章编号] 1673-9701（2017）25-0108-03

Analysis on the clinical value of multi-slice spiral CT three-dimensional reconstruction technique in the diagnosis of traumatic rib fractures

PAN Jinwan QUE Songlin LI Tanghua XIE Kaiqiong

Department of Radiology， Longyan Second Hospital in Fujian Province， Longyan 364000， China

[Abstract] Objective To analyze the diagnostic accuracy of multi-slice spiral CT three-dimensional reconstruction（MSCT） in the diagnosis of traumatic rib fractures and its superiority in the duration of diagnosis. Methods 106 patients with emergency trauma who were given preliminary diagnosis of rib fractures from March 2016 to March 2017 in our hospital were selected as the study subjects. All patients were given digital X-ray radiography and MSCT diagnosis， combined with surgical and pathological diagnosis results. The diagnostic accuracy and diagnostic time of the two diagnostic methods in the diagnosis of rib fractures were compared. Results 117 parts of MSCT rib fracture were detected， with the detection accuracy rate of 98.32%， significantly higher than that of 68.91% in the digital X-ray. There was a significant difference between the two groups（χ2=37.566， P=0.000<0.05）. The duration of multi-slice spiral CT scan and three-dimensional reconstruction technique was significantly shorter than the digital X-ray， and there was a significant difference between the two groups（P<0.05）. Conclusion The diagnosis of rib fractures with MSCT is of high diagnostic accuracy and short diagnostic time， which is suitable for further clinical promotion and application.

[Key words] Traumatic rib fractures； Multi-slice spiral CT； Three-dimensional reconstruction； Accuracy； Superiority

近些年，我國工业化和现代化在不断的突飞猛进，但是由交通事故和工业事故造成的各种形式的创伤也一直处于增长趋势[1]。据相关调查研究表明，创伤性肋骨骨折在我国每年会发生（5～10）万例，在外伤发生率中大约占比1%～2%，成为重要的创伤性损伤[2]。因此，寻找快速、准确、便捷的创伤性肋骨骨折筛选和诊断方法成为医学界最为关注的问题之一。临床上创伤性骨折的诊断多是采用数字X线摄影诊断方法，但是大量临床实践发现，该类诊断手段对于一些非典型性或是隐匿性创伤性肋骨骨折的漏诊现象十分严重[3]。随着医疗科学技术的不断进步，多层螺旋CT联合三维重建技术（MSCT）在临床上开始大范围应用，其具有良好的检测准确性和高分辨性，可作为肋骨骨折诊断的主要依据[4]。……