多层螺旋CT诊断肋骨骨折8例漏诊分析

目的通过回顾性分析2007年以表8例肋骨CT检查漏诊病例，探讨多层螺旋CT诊断肋骨骨折的限度。资料和方法2007年1月至2011年9月127例行肋骨CT检查患者，男83例，女44例，年龄18—88岁，平均51．83岁。应用TOSHIBA AQUILION 16层螺旋CT或GE Lightspeed64层VCT行肋骨CT扫描，扫描数据传至工作站，应用多平面重组（multiplanar reconstruction，MPR）、曲面重组（curved planar reformation，CPR）、容积再现（volume rendering，VR）、电影显示等方法观察骨折情况。结果127例患者中，共检出骨折患者115例，骨折565处。14例复查患者中，6例骨折情况无变化。另有8例可见原未显示的新骨折，共检出14处。结论虽然MSCT作为诊断肋骨骨折的必要检查手段有重要意义，但是它存在一定的局限性。因此，我们对可能发生的“隐匿性骨折”嫡例应提示必要复查，避免医疗纠纷发生。

The Analysis of 8 Missed Diagnosis of Rib Fracture by Multi-slice CT

Objective To investigate the limitation of diagnosing rib fracture by multi-slice CT(MSCT)through retrospective analysis of 8 missed diagnosis of rib fracture since 2007.Methods 127 patients from Jan.2007 to Sep.2011,83 male and 44 female,the scope of age from 18 to 88,the average age was 51.83 years old.Applied TOSHIBA AQUILION 16Slice Spiral CT or GE Lightspeed 64-Slice VCT for scanning,scanning data transferred to workstation.Observed ribs by MPR,CPR,VR and film visualizing method.Results Of the 127 patients,115 patients were found 565 fractures.Among the 14 patients of reexamination,6 patients had no discrepancy and 8 patients had total 14 new fractures which were not found in the first diagnosis.Conclusion MSCT examination is a important method for diagnosing rib fracture,but it have some limitations.So,patients who maybe have occult fracture should be known that reexamination is necessary,in order to avoid medical disputes.