论文部分内容阅读
比较X线能量密度减影(DES)与低剂量多层螺旋CT(MSCT)检查用于隐匿性肋骨骨折的诊断价值.[方法]回顾性分析本院收治的118例高度疑似肋骨骨折患者的影像资料,所有患者均行于创伤后3d内行DES及低剂量 MSCT检查,并与“金标准”4~8周后的常规剂量 MSCT的结果作比较.[结果]经常规 MSCT诊断,118例患者中有147处肋骨骨折,其中88处被确诊为隐匿性肋骨骨折.低剂量 MSCT诊断隐匿性肋骨骨折的敏感度为97.40%(75/77),特异度为81.43%(57/70),符合率为89.80%(132/147).DES诊断隐匿性肋骨骨折的敏感度为96.25%(77/80),特异度为83.58%(56/67),符合率为90.48%(133/147).两种诊断方法敏感度、特异度及符合率比较差异无统计学意义(P>0.05).[结论]短期内首次DES与低剂量 MSCT检查对于隐匿性肋骨骨折患者诊断价值相当,临床上可根据患者具体情形及疾病适应证选择不同检查方法.“,”Tocomparethediagnosticvalueofthefirstdualenergysubtraction (DES)andlow-dosemulti-slicespiralCT (MSCT)inthediagnosisofconcealed/occultribfracturesinashortperiodoftime.[Methods]Theimagingdataof118highlysuspectedribfracturepatientsadmittedtoourhospitalfrom October 2017toOctober2018 wereretrospectivelyanalyzed.AllpatientsunderwentDESandlow-dose MSCT within3 daysaftertrauma.Theresultswerecompared withgoldstandardimagedatawhich werecollected withroutine doseofMSCTafter4~8weeks.[Results]Ofthe118patientsdiagnosedwithconventionalMSCT,147hadrib fractures,ofwhich88werediagnosedasoccultribfractures.Thesensitivity,specificityandcoincidencerateof lowdoseMSCTinthediagnosisofoccultribfracturewere97.40% (75/77),81.43% (57/70)and89.80% (132/147),respectively.ThesensitivityofDESinthediagnosisofoccultribfracturewas96.25% (77/80),the specificitywas83.58% (56/67),andthecoincidenceratewas90.48% (133/147).Therewasnosignificantdiffer-enceinsensitivity,specificityandcoincidenceratebetweenthetwomethods(P>0.05).[Conclusion]DESand low-doseMSCThavecomparablediagnosticvalueinthediagnosisofoccultribfracture.Wecanchoosedifferent examinationmethodsaccordingtothepatient'sspecificsituationandtheindicationofthedisease.