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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Sensation4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组,并将重组图像导入CT三维(3D)工作站,利用多平面重组成像(MPR)、最大密度投影(MIP)、表面阴影法成像(SSD)及容积成像技术(VRT)对图像进行后处理,由2名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、VRT3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”。
Objective To investigate the method of multi-slice spiral CT (MSCT) costal cartilage imaging and its value in the diagnosis of costal cartilage injury. Methods Thirty-six cases of thoracic trauma and 100 cases of control group were scanned by Sensision4 multi-slice spiral CT scanner according to the conventional chest scanning conditions. Then the low-contrast and high-contrast images were reconstructed. The reconstructed images were imported into CT three-dimensional 3D) workstation, the images were post-processed using multiplanar reconstruction imaging (MPR), maximum density projection (MIP), surface shadow imaging (SSD) and volumetric imaging (VRT) After processing the image for observation and analysis. Results All subject’s post-MSCT images showed costal cartilage. The normal costal cartilage was characterized by uniform density, regular pattern and smooth surface. Six cases of costal cartilage injury were found in 10 cases. The density of costal cartilage was uneven or there were cracks in them, and 2 cases were crushed. There was no significant difference in image quality between MIP, SSD and VRT imaging modes (χ2 = 1.356, P = 0.716). There was significant difference in image quality between MIP, SSD, VRT imaging modes and MPR imaging modes (UMIP: MPR = 12.981, USSD: MPR = 12.652, UVRT: MPR = 12.937, P = 0.000). Conclusion MSCT is the best imaging method for non-invasive evaluation of costal cartilage morphology. The related CT findings are expected to become the gold standard for the diagnosis of costal cartilage injury.