目的:探讨DR双能量减影技术骨组织像在外伤性肋骨骨折中的诊断价值.方法:回顾性分析252例有胸部外伤史并怀疑肋骨骨折的患者,进行随机分组,每组126例,分别行DR双能量减影技术与常规DR胸部标准片检查.所有影像图像均由1名副主任医师和2名主治医师进行诊断分析,诊断意见一致时确定是否有肋骨骨折,意见不一致时行CT三维重建及随访确诊.结果:A组患者确诊肋骨骨折共353处,DR双能量减影技术发现肋骨骨折338处,确诊率95.8％,假阳性7处,假阳性率2.0％;B组确诊肋骨骨折共321处,胸部标准像发现肋骨骨折237处,确诊率73.8％,假阳性4处,假阳性率1.2％.确诊率经统计学检验有差异性(x2=64.46,P＜0.05),假阳性率无统计学差异性(x2=0.33,P＞0.05).结论:DR双能量减影技术骨组织像在诊断肋骨骨折,尤其是隐匿部位肋骨骨折的显示方面优于标准胸片,其假阳性方面无显著差别,可作为常规胸片的补充方法,值得临床推广应用.%Objectiive To discuss the diagnostic value of DR dual energy subtraction bone imaging for traumatic rib fracture.Methods A retrospective analysis of 252 cases with chest trauma history and suspicious rib fracture were performed,who were divided equally into two groups at random for DR dual energy subtraction bone imaging and conventional DR examination respectively.The images acquired were analyzed by a co-chief physician and two attending physicians and CT 3D reconstruction and follow-up were carried out when the three staffs could not obtain consistency.Results In Group A,there were 353 rib fractures,and 338 ones were found by DR dual energy subtraction bone imaging,with the diagnosis rate of 95.8％; there were 7 false positive cases with the rate of 2.0％.In Group B,there were 321 rib fractures,and 237 ones were found by conventional DR examination,with the diagnosis rate of 73.8％; there were 4 false positive cases with the rate of 1.2％.For the two groups,there was significant difference between their diagnosis rates (x2=64.46,P＜0.05),while no statistical difference between their false positive rate (x2=0.33,P＞0.05).Conclusion DR dual energy subtraction bone imaging behaves better than conventional DR for the diagnosis of the rib fracture,especially the occult fracture,while has no statistical difference in the false positive rate from conventional DR,which is worth popularizing as a supplement of conventional chest radiograph.
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