CAJ | 학술논문

目的：探讨64排螺旋 CT 多种后处理技术对肋骨骨折的诊断价值。方法回顾性分析92例肋骨骨折患者64排螺旋CT 薄层扫描数据,分别记录4种后处理技术[多层面重建(MPR)、曲面重建(CPR)、容积再现(VR)及最大密度投影(MIP)图像]诊断肋骨骨折的位置、数量及类型。比较4种后处理图像诊断肋骨骨折的准确率,并对其诊断效能进行统计分析。结果92例患者经随访复查或外科手术证实,发现451处肋骨骨折,完全性骨折262处,不完全性骨折189处。4种后处理技术对肋骨骨折的诊断两两比较差异均有统计学意义(P <0.05),CPR 优于其他技术。在完全性肋骨骨折中,CPR 或 MPR 与 VR 对显示肋骨骨折的差异无统计学意义(P >0.05),CPR 或 MPR 与 MIP,VR 与 MIP 对显示肋骨骨折的差异有统计学意义(P <0.05),MIP 显示完全性骨折最差。在不完全性肋骨骨折中,4种后处理技术除 VR 与 MIP 之间无统计学意义(P >0.05),其余两两之间比较差异均有统计学意义(P <0.05)。结论64排螺旋 CT 后处理技术对肋骨骨折诊断有重要的临床应用价值；CPR 对肋骨骨折的诊断效能高于 MPR、VR 和 MIP,MIP 最差,CPR 可作为肋骨骨折的首选诊断方法。
목적：탐토64배라선 CT 다충후처리기술대륵골골절적진단개치。방법회고성분석92례륵골골절환자64배라선CT 박층소묘수거,분별기록4충후처리기술[다층면중건(MPR)、곡면중건(CPR)、용적재현(VR)급최대밀도투영(MIP)도상]진단륵골골절적위치、수량급류형。비교4충후처리도상진단륵골골절적준학솔,병대기진단효능진행통계분석。결과92례환자경수방복사혹외과수술증실,발현451처륵골골절,완전성골절262처,불완전성골절189처。4충후처리기술대륵골골절적진단량량비교차이균유통계학의의(P <0.05),CPR 우우기타기술。재완전성륵골골절중,CPR 혹 MPR 여 VR 대현시륵골골절적차이무통계학의의(P >0.05),CPR 혹 MPR 여 MIP,VR 여 MIP 대현시륵골골절적차이유통계학의의(P <0.05),MIP 현시완전성골절최차。재불완전성륵골골절중,4충후처리기술제 VR 여 MIP 지간무통계학의의(P >0.05),기여량량지간비교차이균유통계학의의(P <0.05)。결론64배라선 CT 후처리기술대륵골골절진단유중요적림상응용개치；CPR 대륵골골절적진단효능고우 MPR、VR 화 MIP,MIP 최차,CPR 가작위륵골골절적수선진단방법。
Objective To evaluate the diagnostic value of post-processing techniques of 64-slice spiral CT on rib fracture.Methods The CT images of 92 patients with rib fractures were analized retrospectively.Four techniques were used to evaluate the accuracy of the diagnostic on rib fracture seperately.The techinques which used were multiplanar reconstruction (MPR),curved surface re-construction (CPR),volume rendering (VR)and maximum intensity projection (MIP).Results A total of 45 1 rib fractures among 92 patients were confirmed during follow-up or in surgery,which included 262 complete fractures and 189 incomplete fractures.Sta-tistically significant difference was found between any two post-processing techniques(P <0.05),which CPR showed superiority in the diagnosis of rib fractures.In subgroup analysis of complete fractures,there were no statistically significant difference between MPR and VR,as well as CPR and VR (P >0.05),which showed superiority compared with MIP (P <0.05).In subgroup analysis of incomplete fractures,no statistically significant between VR and MIP(P > 0.05 ),the difference was statistically significant be-tween the rest (P <0.05).Conclusion All four types of post-processing techniques of 64-slice spiral CT shared an important appli-cation value in the diagnosis of rib fractures.CPR is better than MPR,VR and MIP for the diagnosis of rib fractures,while MIP is the last to consider.CPR can be used as the perferred diagnostic method for rib fractures.