摘要
目的:比较数字X线摄影(DR)和多层螺旋CT(MSCT)在肋骨骨折诊断中的确诊率,评价其在法医临床鉴定中的作用。方法:观察80例肋骨骨折患者的DR正、斜位片,MSCT容积再现(VR)、最大密度投影(MIP)、多平面重组(MPR)及薄层轴位图像,对比分析两种影像学检查方法在肋骨骨折确诊率、漏诊率和疑诊率方面的差异。结果:DR确诊65例188处,确诊率73.44%(188/256);可疑19处,疑诊率7.44%(19/256);漏诊49处,漏诊率为19.14%(49/256)。MSCT确诊79例253处,确诊率98.05%(251/256);可疑3处,疑诊率1.17%(3/256);漏诊2处,漏诊率为0.78%。DR组与MSCT组对肋骨骨折的确诊率、漏诊率具有明显统计学意义。结论:MSCT对肋骨骨折的确诊率明显高于DR,是法医临床鉴定的可靠检查方法。
Objective： To investigate the diagnostic value of multi-slice spiral CT （MSCT） for rib fracture with digital radiography （DR） in comparison, and further to assess its potential application value in forensic identification. Methods： For 80 patients with rib fructures, th frontal and oblique DR film and MSCT with varied 3D-reconstruction techniques such as volume rendering （VR）, maximum intensity projection （MIP）, multi-planar reformation （MPR） and thin axial images were analyzed retrospectively. The rates of indenified, suspected and missed diagnosis in rib fracture were compared between MSCT and DR. Results： 65 cases with 188 fractures were correctly diagnosed by DR, with the indenified diagnosis rate 73.44% （188/256）, the suspect diagnosis rate 7.44% （19/256） and the missed diagnosis rate 19.14% （49/256）. 79 cases with 253 fractures were correctly diagnosed by MSCT, with the indenified diagnosis rate 98.05% （251/256）, the suspect diagnosis rate 1.17% （3/256） and the missed diagnosis rate 0.78% （2/256）. There is significant statistic difference between DR and MSCT （P〈 0.01） for diagnosis of rib fracture. Conclusion： The display rate of rib fracture with MSCT 3D-reconstruction was much higher than that of DR. DR can be used as a routine screening examination, and MSCT can provide further definite diagnosis and reliable evidence for clinical forensic identification.
出处
《CT理论与应用研究（中英文）》
2012年第3期549-556,共8页
Computerized Tomography Theory and Applications
关键词
数字X线摄影
多层螺旋CT
肋骨骨折
法医临床鉴定
digital radiography
muti-slice computed tomography
rib fracture
clinical forensic identification
作者简介
作者简介：龚晓虹（1979一），女，湖北医药学院附属太和医院放射影像中心主治医师，主要从事影像诊断工作，Tel：13971913703，E-mail：gxh．Jinmen@yeah．net孟祥志（1963一），男，武汉大学基础医学院法医教研室主任、教授、博士生导师，主要从事法医鉴定工作，E-mail：mengxiangzhi63@163．com。
