目的 分析创伤性脾破裂的CT影像,研究相邻骨骨折的发生情况,并探讨256层CT在诊断创伤性脾破裂合并相邻骨骨折中的应用价值.方法 回顾分析43例创伤性脾破裂的256层CT影像,各病例均以横轴位及VR、MPR等后处理重建方法对相邻骨进行分析观察,判断是否并发骨折,并对骨折的发生率、发生部位及骨折类型加以分析研究.结果 43例脾破裂患者中,共有32例合并相邻骨骨折,发生率为74%,其中男性27例,占84%,女性5例,占16%,男女间发生率无统计学差异(P>0.05).肋骨骨折26例(肋弓骨折3例),占81%,椎体及横突骨折10例,占23%,在所有合并骨折病例中,多发骨折24例,占55%.结论 脾破裂作为严重的腹部创伤,合并相邻骨骨折的发生率高,表现形式多样,且多发骨折占比高.256层CT扫描速度快,事实上提高了图像质量,对观察脾破裂患者相邻骨细微解剖结构,判断是否合并骨折具有重要价值.%Objective To analyze the CT images of traumatic splenic rupture and study the occurrence of adjacent bone frac -tures, also to explore the value of 256-slice CT in diagnosis of traumatic rupture of spleen .Methods The 256-slice CT images of 43 cases with traumatic spleen rupture were retrospectively analysed , all cases were performed with transverse axial , volume ren-dering ( VR) , multi planar reconstruction ( MPR) and other post-processing method to observe the incidence rate , location and type of adjacent bone fracture .Results In 43 cases of splenic rupture patients , 32 cases were mergered adjacent bone fractures , the rate was 74%, which included 27 males ( accounting for 84%) , 5 women ( accounting for 16%) , there was no significant difference between them ( P >0.05).There were 26 cases with rib fractures, which included 3 cases with costicartilage fracture ( accounting for 81%) , 10 cases with vertebral body and processus transversus fractures ( accounting for 23%) .In all cases of bone fracture, there were 24 cases with multiple fractures(accounting for 55%).Conclusion Splenic rupture as a severe ab-dominal trauma mergers high incidence of adjacent bone fractures .The form of fractures are variety , and the rate of multiple frac-tures is high .The scan of 256-slice CT is speedy , which can reduce the patient breath-hold requirement and improve the image quality.It has important value to observe the subtle anatomical structure of the adjacent bone in the spleen rupture , and to deter-mine whether merger bone fracture .
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