Application of MSCT Image Post-Processing Techniques in the Identification of Rib Fracture Malunion.

Objectives: To compare the application value of three image post-processing techniques volume rendering (VR), multiplanar reformation (MPR) and curved planar reformation (CPR) in the identification of rib fracture malunion.

Methods: The types and numbers of rib fracture malunion in 75 patients were recorded, and the sensitivity, specificity, accuracy and Youden index of VR, MPR and CPR in the diagnosis of rib fracture malunion were compared. Receiver operator characteristic (ROC) curve was drawn and area under the curve (AUC) was calculated, and the detection rates of three image post-processing techniques for different types of rib fracture malunion were compared.

Results: A total of 243 rib fractures were malunion in 75 patients. The diagnostic sensitivity of VR, MPR and CPR for rib fracture malunion was 52.67%, 79.84% and 91.36%, the specificity was 99.58%, 97.89% and 99.15%, the accuracy was 83.66%, 91.76% and 96.51%, the Youden index was 0.52, 0.78 and 0.91, the AUC was 0.761, 0.889 and 0.953, respectively. Compared with VR, there were statistically significant differences in the number of broken rib end misalignment over 1/3, broken rib end overlap, broken rib end angulation and intercostal bridge detected in MPR (P<0.05). Compared with VR, there was a statistically significant difference in the number of different types of rib fracture malunion detected by CPR (P<0.05). Compared with MPR, there were statistically significant differences in the number of broken rib end misalignment over 1/3, broken rib end separation and intercostal bridge detected in CPR (P<0.05).

Conclusions: The three image post-processing techniques are of great significance for the identification of rib fracture malunion. Especially CPR is highly effective in the diagnosis of rib fracture malunion, and can be used as the main post-processing technique for forensic clinical identification of rib fracture malunion.