외상에 의한 흉곽 골절에 유용한 다절편 CT의 재구성 영상

Usefulness of MDCT with Reconstructed Images in Trauma Induced Thoracic Fractrue (Comparison with Plain X-ray)

Purpose This article evaluate the usefulness of three-dimensional reconstructive images using multi detector computed tomography (MDCT) in thoracic traumatic patients visiting emergency room clinics for out-patients. Materials and methods 76 patients with fractures of 105 patients who visited our emergency room complaining of thoracic trauma were analyzed retrospectively. All patients performed thoracic MDCT and three-dimensional reconstructive images were taken. Fractures were confirmed by axial CT, clinical information, whole body bone scan, and multi planar reformation images. Plain x-ray was analyzed by fractured sites in a blind comparison of two radiologists’ readings, and then that finding was compared with them of axial CT scans and three-dimensional reconstructive images. Results The fracture sites were rib (n=68), sternum (n=14), clavicle (n=6), scapula (n=3), spine (n=5) and combined fractures (n=14). Plain x-ray and axial CT scans had correspondency of 0.555 for rib fractures. Axial CT scans and three-dimensional reconstructive images had 0.952. For sternal fracture, those were 0.692 and 0.928 each. Axial CT scans and three-dimensional reconstructive images showed sensitivities for rib and other fractures, 94 % and 91 % and for sternal fracture, 93 % and 100 % each. Three-dimensional reconstructive image had high sensitivity in the diagnosis of sternal fracture especially. Conclusion While evaluating thoracic trauma at emergency room, three-dimensional reconstructive image was useful to diagnose extent of fracture easily and very sensitive to detect sternal fracture.