肋骨骨折各种影像学诊断价值及对比分析

目的 探讨肋骨骨折各种影像学诊断价值并对其进行对比分析。方法 63例单发或多发肋骨骨折患者共196处分别进行如下检查：X线平片29例；CR47例；SCT胸部横断11例并薄层重建，薄层横断、倾斜扫描各12例，共35例薄层行2DMPR、3DSSD及MIP重建；MSCT胸部28例并薄层重建2DMPR、3DVK及MIP重建。结果 X线平片、CR、SCT诊断率分别为76．67％、87．68％和94．44％，三者差异有显著性（P〈0．05），即SCT扫描优于CR图像，CR图像优于X线平片。SCT扫描与薄层重建及横断、倾斜扫描、MSCT扫描与薄层重建诊断率分别为94．44％、100％、100％、100％、95．18％和100％，六者差异无显著性（P〉0．05），以薄层显示效果好，诊断率均达100％，为诊断标准。2D重建起辅助诊断作用。SCT及3DSSD、MIP重建、MSCT及3DVK、MIP重建可立体、形象显示骨折，定位效果好，但对轻微骨折显示欠佳，诊断率分别为94．69％、95．58％、97．59％和96．39％。四者差异无显著性（P〉0．05）。结论 SCT、MSCT及其2D、3D重建对肋骨骨折的诊断具有明显的优势，与X线平片或CR的联合应用，具有良好的定性、定量及定位诊断作用。

Value and comparative analysis of X-ray plain film CR SCT MSCT 2D-CT and 3D-CT in diagnosis of rib fracture

[Objective] To analyze and compare the imaging diagnosis value of conventional radiography,CR,SCT,MSCT,2D-CT and 3D-CT of rib fracture.[Methods] 63 patients with rib fracture 196 were examined:29 cases were examined by plain films,47 cases underwent CR,11 cases underwent chest SCT and thin slice reconstruction,24 cases underwent thin slice SCT,35 cases were examined by SCT 2D MPR 3D SSD and 3D MIP respectively;28 cases underwent chest MSCT and thin slice reconstruction,2D MPR 3D VR and 3D MIP respectively.[Results] Accurate rate is 76.67%,87.68%,94.44% respectively diagnosed by X-ray plain film,CR and transverse SCT.Statistical difference between them is value(P <0.05).The Diagnosis accurate rate in SCT transverse scanning and thin slice reconstruction,slope scanning,MSCT scanning and thin slice reconstruction is 94.44%,100%,100%,100%,95.18%,100%,respectively.And have no statistical difference(P >0.05).The diagnosis rate in thin slice scanning and reconstruction is 100%.SCT and MSCT with thin slice scanning play a standard role in diagnosis.2D MPR play an assistant role in diagnosis.In SCT,3DSSD,MIP,MSCT,3DVR and MIP reconstruction image,fracture demonstrate truly and could be viewed 3D.The Diagnosis accurate rate is 94.69%,95.58%,97.59%,96.39% respectively.And have no statistical difference(P >0.05)between them.[Conclusion] SCT,MSCT,2D and 3D reconstruction imaging have distinctive advantage in rib fracture diagnose,combination of conventional radiography and CR,the value of character and location diagnose of the fib fracture is best.