董志辉,杨志刚,王戚玲,陈天武,李媛,褚志刚.多层螺旋CT及其三维重组诊断地震压砸伤胸部骨折[J].中国医学影像技术,2009,25(5):859~862
多层螺旋CT及其三维重组诊断地震压砸伤胸部骨折
Value of MSCT with three-dimensional reformation in the diagnosis of crush thoracic fractures arising from earthquake
投稿时间:2008-11-05  修订日期:2009-02-05
DOI:
中文关键词:  地震  胸部  骨折  体层摄影术,X线计算机
英文关键词:Earthquake  Thorax  Fractures, bone  Tomography, X-ray computed
基金项目:
作者单位E-mail
董志辉 四川大学华西医院放射科,四川 成都 610041  
杨志刚 四川大学华西医院放射科,四川 成都 610041 yangzg1117@yahoo.com.cn 
王戚玲 四川大学华西医院放射科,四川 成都 610041  
陈天武 四川大学华西医院放射科,四川 成都 610041  
李媛 四川大学华西医院放射科,四川 成都 610041  
褚志刚 四川大学华西医院放射科,四川 成都 610041  
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中文摘要:
       目的 探讨MSCT及其三维重组技术对地震压砸伤患者胸部骨折的诊断价值。方法 回顾性分析135例地震压砸伤患者胸部骨折的MSCT表现和三维重组图像的诊断优势。结果 135例患者共发现肋骨骨折100例,严重肋骨骨折包括第1、2肋骨骨折50例, 3支或3支以上肋骨骨折81例和连枷胸36例;非肋骨骨折包括胸椎、胸骨、肩胛骨和锁骨骨折共59例,非肋骨骨折出现与否与严重肋骨骨折的发生之间有明显相关性。结论 地震所造成的压砸性胸部骨折中,严重肋骨骨折的发生率高。非肋骨骨折与严重肋骨骨折的发生之间有明显相关性,可以作为判断患者胸部压砸伤严重程度的良好指标。MSCT三维重组对胸部细微骨折的诊断价值高于常规轴位图像。
英文摘要:
      Objective To evaluate the diagnostic value of multi-slice spiral computed tomography (MSCT) with three-dimensional reformations in crush thoracic fractures arising from the Wenchuan earthquake. Methods MSCT features of thoracic fractures of 135 patients and the advantage of three-dimensional reformated images were retrospectively analyzed. Results Among 135 patients, 100 patients with rib fractures were detected by MSCT, including 50 cases with the first and/or second rib fractures, 81 cases with 3 or more rib fractures, and 36 cases with flail chest. Bone fractures involved thoracic spine, sternum, scapula and/or clavicle were detected in 59 cases, which correlated well with severe rib fractures. Conclusion In the patients with crush thoracic fractures caused by earthquake, the incidence of severe rib fractures was rather high. Accordingly, bone fractures involved thoracic spine, sternum, scapula and/or clavicle correlated well with severe rib fractures, which may be useful for indicating the severity of crush thoracic injuries. Three-dimension reformation images can provide more diagnostic confidence in tiny bone fractures than conventional axial MSCT images.
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