多層螺旋CT 肋軟骨成像及在診斷肋
軟骨損傷中的臨床應用
向子云 羅良平 韋日宇 陳金城
【摘要】 目的 探討多層螺旋CT( MSCT) 肋軟骨成像方法及其在肋軟骨損傷診斷中的價值。
方法 利用西門子Sensation 4 多層螺旋CT 機按照胸部常規掃描條件對胸部外傷組36 例和對照組
100 例患者進行容積掃描, 然后進行薄層低對比及高對比圖像重建, 并將重建圖像導入CT 三維( 3D)
工作站, 利用多平面重建成像( MPR) 、最大密度投影( MIP) 、表面遮蓋法成像( SSD) 及容積成像技術
( VRT) 對圖像進行后處理, 由2 位CT 診斷醫生一起對各種后處理圖像進行觀察和分析。結果 所有
受檢者的MSCT 后處理圖像均能顯示肋軟骨。正常肋軟骨表現為周圍密度均勻、形態規則、表面光
滑; 肋軟骨損傷6 例10 處, 表現為肋軟骨密度不均勻或者其中有裂隙, 2 例呈粉碎狀。MIP、SSD、VRT
3 種成像模式間圖像質量差異無統計學意義( χ2 = 1. 356, P = 0. 716 ) , MIP、SSD、VRT 成像模式與
MPR 成像模式間圖像質量比較差異均有統計學意義( UMIP: MPR = 12. 981, USSD:MPR = 12. 652, UVRT: MPR
= 12. 937, P 值均= 0. 000) 。結論 MSCT 是1 種無創傷性顯示肋軟骨形態的最佳影像學方法, 其相
關CT 表現可望成為臨床診斷肋軟骨損傷的“ 金標準”。
【關鍵詞】 體層攝影術, X 線計算機; 肋骨; 創傷和損傷
The imaging and diagnostic value of costica rtila ge injur ies on multi-slice CT XIANG Zi-yun* ,
LUO Liang-ping, WEI Ri-yu, CHEN J in-cheng. * Department of Medical Imaging, , LongGang District
Hospital, Shenzhen 518172, China
【Abst ract 】 Objective To investigate the imaging methods of multi-slice CT ( MSCT) in
costicartilage and the diagnostic value in the costicartilage injuries. Methods There were 100 cases in
normal group and 36 cases in group of chest injuries. All cases were performed in volume scan according to
conventional chest scan by SIEMENS Sensation 4 MSCT, then performed in thin slice low and high contrast
image reconstructions. After that, all the source images were input into CT 3D workstations, costicartilage
were imaged by postprocessing software such as multiplanar reconstructions ( MPR) , maximum intensity
projection( MIP) , surface shade display( SSD) and volume rendering technique ( VRT) . All the pictures
were observed and analyzed by two radiologists. Results All postprocessed images that obtained from the
MSCT could show the costicartilage clearly. Normal costicartilage displayed uniform density, regular shape
and smooth surface; there were 6 injuries in 10 cases with costicartilage injuries, which displayed no
uniformity density or cranny in costicartilage and showed cranny in 2 cases. No significant difference of
image quality was found among the three imaging modes of MIP、SSD、VRT( χ2 = 1. 356, P = 0. 716 ) .
Significant differences were found between MPR and other three imaging modes( UMIP :MPR = 12. 981, USSD: MPR
= 12. 652, UVRT:MPR = 12. 937, P = 0. 000 ) . Conclusion So far, the MSCT is the best noninvasive
imaging method to show the shape of costicartilage, it may be considered as a clinical“ gold standard”in the
diagnosis of costicartilage injury.
【Key wor ds】 Tomography, X-ray computed; Ribs; Wounds and injuries

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