摘要
目的探讨螺旋CT后处理技术曲面重建(curved planar reconstruction,CPR)在肋骨内固定手术中的应用价值。方法收集外伤性肋骨骨折并进行手术患者83例,所有患者均在术前行胸部CT平扫,并对CT扫描数据进行肋骨CPR及容积再现(volume rendering,VR)处理,根据肋骨CPR、VR及CT平扫图像设计手术方案,术中验证结果。结果通过对肋骨CPR、VR两种后处理技术两两比较,在发现骨折、量化错位超过1/2的骨折、发现不完全骨折、发现碎骨片四个方面表明CPR明显优于VR,差异均有统计学意义(P<0.05)。通过肋骨CPR图像可以更直观的了解骨折的具体形态及细节。CPR检查诊断的灵敏性、特异性、阳性率、准确性均高于VR检查,阴性率、漏诊率、误诊率均低于VR检查。经ROC曲线下面积分析发现,CPR和VR均对肋骨骨折有明确诊断价值,CPR曲线下面积为0.976高于VR曲线下面积0.910,说明CPR诊断价值高于VR(P<0.05)。结论螺旋CT的CPR技术能准确判定肋骨细微骨折的类型、清晰显示骨折断端的细节,对于肋骨内固定手术术前制定手术方案有一定指导作用。
Objective To investigate the application value of spiral CT curved surface reconstruction(CPR)in internal fixation of rib fracture.Methods A total of 83 patients with traumatic rib fractures who underwent surgical treatment were enrolled in the study.All patients received chest CT plain scan before surgery,and underwent rib CPR and volume rendering(VR)for CT scan data.According to CPR images of rib,VR images and CT plain scan images,a surgical plan was designed to verify the results during surgery.Results The CPR was superior to VR in the diagnosis of fractures,quantification of fractures with displacement more than 1/2,diagnosis of incomplete fractures and discovery of bone fragments(P<0.05).Through the CPR images,the specific shape and details of the fracture could be more intuitively understanded.The sensitivity,specificity,positive rate and accuracy of CPR examination were higher than those by VR examination.The negative rate,missed diagnosis rate and misdiagnosis rate were lower than those by VR examination.According to the area analysis under the ROC curve,both CPR and VR had clear diagnostic value for rib fracture.The area under the CPR curve was 0.976 in CPR examination,which was significantly higher than that(0.910)by VR examination,which indicated that the diagnostic value of CPR was significantly higher than that by VR(P<0.05).Conclusion The CPR technique of spiral CT can accurately determine the type of slight rib fracture and clearly show the details of the fracture end,which has a certain guiding role in the preparation of surgical plan before the operation of internal fixation of the ribs.
作者
周志刚
黄斐
杨金良
张萌
黄刚
曹利娟
ZHOU Zhigang;HUANG Fei;YANG Jinliang(Department of Thoracic Surgery,The Third Hospital of Hebei Medical University,Hebei,Shijiazhuang 050051,China)
出处
《河北医药》
CAS
2019年第22期3401-3404,共4页
Hebei Medical Journal
基金
河北省医学科学研究重点课题计划(编号:20160613)
关键词
后处理技术
肋骨骨折
骨折内固定术
post-processing technique
rib fractures
fracture internal-fixation
