多层螺旋CT三维重建诊断肋骨骨折的应用价值

目的 探讨多层螺旋CT三维重建诊断肋骨骨折的应用价值。资料与方法 对71例胸部外伤患者行多层螺旋CT扫描后,运用容积再现技术及曲面重建技术显示肋骨骨折的部位、数量,并与胸部平片对照分析,判断多层螺旋CT三维重建诊断肋骨骨折的优缺点。结果 肋骨骨折以4-10肋（82.3%）、腋段（51.0%）常见。胸部平片诊断了59例（83.1%）、165条（86.0%）肋骨骨折。多层螺旋CT发现了胸部平片漏诊的12例（16.9%）27条（14.0%）肋骨骨折。胸部平片漏诊的肋骨骨折多为无移位或靠近肋软骨、胸椎的骨折。多层螺旋CT三维重建明确了68例（95.8%）、185条（96.4%）肋骨骨折。结论 多层螺旋CT曲面重建及VRT对肋骨骨折的诊断优于胸部平片,对治疗方案的选择及预后评估具有重要价值。

The value of 3D multi-slice helical CT in the diagnosis of the rib fractures

Objective To investigate the value of 3D multi-slice helical CT( MSCT) in the diagnosis of the rib fractures. Methods 71 thorax injured patients were examined by MSCT, the position and number of rib fractures were displayed by Multiplanar reconstruction (MPR) and volume rendering technique (VRT) of MSCT , then compared with chest plain in order to find the advantages and disadvantages in the diagnosis of rib fracture by 3D MSCT. Results The majority of rib fractures were located in 4-10 rib (82. 3%) and axils segment (51.0%) . 165 rib fractures (86.0%) in 59 cases (83.1%) were displayed by chest plain. 12 cases rib fractures (16.9%) were missed by chest plain, most of those near the rib cartilage or thorax vertebra, 3D MSCT displayed all those fractures . 3D MSCT confirmed 68 cases (95.8%), 185 rib fractures (96. 4 %). Conclusion The Multiplanar reconstruction (MPR) and volume rendering technique (VRT) of MSCT in the diagnosis of the rib fractures are better than chest plain, and also play an important role in selecting therapy project and evaluating prognosis.