摘要
目的:总结MSCT在肋骨骨折诊断不当的原因,提高MSCT检查肋骨骨折的检出率和正确率。方法:回顾性分析我院173例肋骨骨折患者的资料。首次MSCT在骨折后1周内进行,并于创伤2周后复查。以Wilcoxon配对符号秩和检验说明两次(首次及复查诊断)诊断结果存在差异。由2名放射科高年资医师在已知复查骨折数目的前提下,分析首次MSCT骨折数目不同的原因。对其原因分三类,即漏诊、误诊及假阴性。结果:173例病患者中,首次MSCT共检出肋骨骨折552处,复查MSCT共检出肋骨骨折729处。两次诊断结果差异有统计学意义(Z值=7.881,P<0.01)。复查MSCT诊断比首次多了213处,其中漏诊83处,占38.96%,误诊18处,占8.45%,假阴性112处,占52.58%。结论:MSCT诊断肋骨骨折存在一定的局限性,应仔细对图像进行综合分析,并加强随访复查。
Purpose： To summarize the causes of misdiagnosis of rib fracture by multi-slice CT （MSCT）, and to improve the detection rate and accuracy of rib fracture. Methods： One hundred and seventy-three patients in our hospital who suffered rib fracture were analyzed retrospectively. All of them were examined by MSCT during first week, and reexamined about 2 weeks after trauma. The differences of the diagnosis results were analyzed using the Wilcoxon signed rank sum test. Base on the fracture number known by reexamination, two senior radiologists analyzed the reason why the MSCT fractures number was different from the first time. The reasons can be summarized into three kinds： missed diagnosis, misdiagnosis and false negative. Results： Five hundred and fifty-two fractures were found at first MSCT for 173 patients, and 728 fractures were found at MSCT reexamination, the difference was with statistical significance （Z=7.881, P〈0.01）. MSCT reexamination detected more rib fractures （213） than the first time. Among them, 83 rib fractures （38.96%） were missed diagnosis, 18 rib fractures （8.45%） were misdiagnosed, 112 rib fractures （52.58%） were false negative. Conclusion： MSCT diagnosis of rib fracture has certain limitations, comprehensive analysis should be conducted carefully for the images and the follow up reexamination should be strengthened.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2017年第4期357-360,共4页
Chinese Computed Medical Imaging
