螺旋CT后处理技术Unfold Display在隐匿性肋骨骨折中的诊断价值

The Value of Unfold Display of Spiral CT Post-Reconstruction Technique in the Diagnosis of Occult Rib Fracture

摘要: 目的：探讨64排螺旋CT后处理技术Unfold Display对隐匿性肋骨骨折的诊断价值。方法：回顾性分析87例胸部外伤行DR摄片可疑骨折或无明显异常的行MSCT容积扫描，将所得原始数据经工作站进行MPR (对容积扫描所得图像数据进行重组，得到冠状位、矢状位以及任意斜位的二维重建图像，可以从不同方位、不同角度、任意平面进行细致和准确观察骨折情况，达到切线观察骨折的效果)、VR (对容积扫描所得图像数据进行三位重建，可以多方位、多角度旋转，能得到干净、清晰、层次分明、立体直观的肋骨图像，完全显示胸廓肋骨解剖学关系)及Unfold Display (软件利用CT薄层数据通过与内置模板匹配确定所有肋骨的中心线，通过沿中心线的CPR重组技术获得拉伸后的胸廓图像，每一个肋骨的拉伸图像均与脊柱相连，并显示每一个肋骨的左右与编号)后处理，比较各种重建对隐匿性肋骨骨折的诊断能力。结果：CT随访图像确诊肋骨骨折179处，其中MPR显示骨折175处(97.8%)、VR显示骨折156处(87.1%)、Unfold Display显示骨折171处(95.5%)。Unfold Display与MPR比较，差异无统计学意义(P > 0.05)，Unfold Display与VR比较，差异有统计学意义(P < 0.05)。结论：Unfold Display可以对急性胸部创伤隐匿性肋骨骨折做出准确快速的判断，对于指导临床治疗具有重要意义。

Abstract: Objective: To investigate the diagnostic value of Unfold Display of 64-slice spiral CT post-reconstruction technique in occult rib fracture. Methods: Retrospective analysis of 87 patients, with definite chest trauma and whose chest X-ray examination of suspicious fracture or no obvious abnormality given MSCT volume scanning. All the original images were transferred to workstation to be post-processed to obtain multi-planar reformation (The image data obtained by volume scanning is reconstructed, the two-dimensional reconstruction images of coronal, sagittal and arbitrary oblique positions were obtained, and the fracture can be observed carefully and ac-curately from different directions, angles and any plane, so to tangent to observe the effect of fracture), volume rendering (Three-dimensional reconstruction of image data from volume scan-ning, can rotate from all the aspects concerned, and can get a clean, clear, distinct, stereo intuitive frame image, fully showed thoracic ribs anatomy relationship), Unfold display (Software using CT thin layer data with built-in template matching to determine all the center of the frame by recom-binant technology along the center line of CPR stretch after thoracic images, each frame drawing images are connected to the spine, and displays each frame around and number) images in order to reveal occult rib fractures clearly and rapidly. Results: One hundred and seventy-nine rib fractures were diagnosed by following-up imagines of CT, where one hundred and seventy-five were detected by multi-planar reformation, one hundred and fifty-six were found by volume rendering, and one hundred and seventy-one were found by unfold reconstructions. There was not statistical difference in the diagnosis accuracy of rib fracture using unfold reconstructions and multi-planar reformation (P > 0.05). There was statistical difference in the diagnosis accuracy of rib fracture using unfold reconstructions and volume rendering (P < 0.05). Conclusion: Unfold Display can diagnose the occult rib fracture clearly and rapidly in chest trauma. It is of great significance for guiding clinical treatment.