目的 探讨64排螺旋CT多种后处 理技术对肋骨骨折的诊断价值。方法 以 本院2014年2月-2016年2月就诊的疑似肋 骨骨折75例胸部外伤患者为研究对象，均 行X线平片、多层螺旋CT轴位、容积再现 (VR)、多平面重建(MPR)等后处理技术检 查，比较不同影像学方法对肋骨骨折、骨 折数量检出情况。结果 临床、影像学检 查及复查确诊肋骨骨折165处，CT轴位、 CT后处理技术对肋骨骨折例数检出率分别 为96.00%、98.67%，较X线平片的80.00% 差异有统计学意义(P＜0.05)。CT后处理 技术对肋骨骨折数量检出率为99.39%，较 X线平片、CT轴位的71.52%、78.79%差异 有统计学意义(P＜0.05)。漏诊情况：X线 平片漏诊41处，其中以肋软骨附近漏诊最 多，占58.54%；CT轴位漏诊24处，其中肋 软骨附近、腋段肋骨漏诊各5处；CT后处 理技术未漏诊，可疑骨折数1处。结论 64 排螺旋CT后处理技术对肋骨骨折、骨折数 量检出率高，漏诊率低，能有效弥补X线 平片、CT轴位不足。

Objective To investigate the value of various post processing techniques of 64 slice spiral CT in the diagnosis of rib fractures. Methods 75 cases of patients with thoracic trauma and suspected rib fractures who were treated in our hospital between February 2014 and February 2016 were selected as study subjects. All of them were examined by X-ray plain film, multi-slice spiral axial CT, volume rendering (VR), multi planar reconstruction (MPR) and other post-processing techniques. The situation of different imaging methods in the detection of rib fractures and number of fractures was compared. Results 165 rib fractures were diagnosed by clinical, imaging examination and reexamination. The detection rates of axial CT and CT post processing techniques in number of cases with rib fractures were 96.00% and 98.67%, respectively. Compared with X-ray plain film (80.00%), the difference was significant (P<0.05). The detection rate of CT post processing techniques in number of rib fractures was 99.39%. Compared with that of X-ray plain film (71.52%) and axial CT (78.79%), there were significant differences (P<0.05). In terms of missed diagnosis, 41 fractures were missed diagnosed by X-ray plain film and the most fractures missed diagnosed located around rib cartilage, accounting for 58.54%. Axial CT missed diagnosed 24 sites, in which 5 sites around the rib cartilage and 5 sites at axillary rib were missed diagnosed; There were no sites missed diagnosed by CT post processing techniques, with 1 suspected fracture. Conclusion The detection rates of 64 slice spiral CT in rib fractures and number of fractures are high, and the rate of missed diagnosis is low, which can effectively make up for X-ray film and axial CT.