多层螺旋CT 肋软骨成像及在诊断肋软骨损伤中的临床应用

多层螺旋CT 肋软骨成像及在诊断肋
软骨损伤中的临床应用
向子云 罗良平 韦日宇 陈金城
【摘要】 目的 探讨多层螺旋CT( MSCT) 肋软骨成像方法及其在肋软骨损伤诊断中的价值。
方法 利用西门子Sensation 4 多层螺旋CT 机按照胸部常规扫描条件对胸部外伤组36 例和对照组
100 例患者进行容积扫描, 然后进行薄层低对比及高对比图像重建, 并将重建图像导入CT 三维( 3D)
工作站, 利用多平面重建成像( MPR) 、最大密度投影( MIP) 、表面遮盖法成像( SSD) 及容积成像技术
( VRT) 对图像进行后处理, 由2 位CT 诊断医生一起对各种后处理图像进行观察和分析。结果 所有
受检者的MSCT 后处理图像均能显示肋软骨。正常肋软骨表现为周围密度均匀、形态规则、表面光
滑; 肋软骨损伤6 例10 处, 表现为肋软骨密度不均匀或者其中有裂隙, 2 例呈粉碎状。MIP、SSD、VRT
3 种成像模式间图像质量差异无统计学意义( χ2 = 1. 356, P = 0. 716 ) , MIP、SSD、VRT 成像模式与
MPR 成像模式间图像质量比较差异均有统计学意义( UMIP: MPR = 12. 981, USSD:MPR = 12. 652, UVRT: MPR
= 12. 937, P 值均= 0. 000) 。结论 MSCT 是1 种无创伤性显示肋软骨形态的最佳影像学方法, 其相
关CT 表现可望成为临床诊断肋软骨损伤的“ 金标准”。
【关键词】 体层摄影术, X 线计算机; 肋骨; 创伤和损伤
The imaging and diagnostic value of costica rtila ge injur ies on multi-slice CT XIANG Zi-yun* ,
LUO Liang-ping, WEI Ri-yu, CHEN J in-cheng. * Department of Medical Imaging, , LongGang District
Hospital, Shenzhen 518172, China
【Abst ract 】 Objective To investigate the imaging methods of multi-slice CT ( MSCT) in
costicartilage and the diagnostic value in the costicartilage injuries. Methods There were 100 cases in
normal group and 36 cases in group of chest injuries. All cases were performed in volume scan according to
conventional chest scan by SIEMENS Sensation 4 MSCT, then performed in thin slice low and high contrast
image reconstructions. After that, all the source images were input into CT 3D workstations, costicartilage
were imaged by postprocessing software such as multiplanar reconstructions ( MPR) , maximum intensity
projection( MIP) , surface shade display( SSD) and volume rendering technique ( VRT) . All the pictures
were observed and analyzed by two radiologists. Results All postprocessed images that obtained from the
MSCT could show the costicartilage clearly. Normal costicartilage displayed uniform density, regular shape
and smooth surface; there were 6 injuries in 10 cases with costicartilage injuries, which displayed no
uniformity density or cranny in costicartilage and showed cranny in 2 cases. No significant difference of
image quality was found among the three imaging modes of MIP、SSD、VRT( χ2 = 1. 356, P = 0. 716 ) .
Significant differences were found between MPR and other three imaging modes( UMIP :MPR = 12. 981, USSD: MPR
= 12. 652, UVRT:MPR = 12. 937, P = 0. 000 ) . Conclusion So far, the MSCT is the best noninvasive
imaging method to show the shape of costicartilage, it may be considered as a clinical“ gold standard”in the
diagnosis of costicartilage injury.
【Key wor ds】 Tomography, X-ray computed; Ribs; Wounds and injuries

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