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目的探讨鼻骨骨折高频超声表现与CT检查对照分析,以提高鼻骨骨折的超声诊断水平。方法选择2015年1月至2017年3月深圳市龙岗区耳鼻咽喉医院有外伤史的疑似闭合性鼻骨骨折154例患者,其中男性97例,女性57例;年龄14~54岁,中位年龄35.9岁。以CT检查为参照,回顾性分析闭合性鼻骨骨折患者的超声图像特点,即鼻骨骨折分为线型骨折、粉碎型骨折、复合型骨折、不完全型骨折等4种类型超声声像图特征。结果 154例鼻骨骨折患者中,CT检查单纯线型骨折53例,粉碎型骨折39例,复合型骨折45例,不完全型骨折7例,未发现骨折10例;超声检查单纯线型骨折67例,粉碎型骨折42例,复合型骨折18例,不完全型骨折13例,14例未发现骨折声像。超声检查和CT检查的诊断阳性率差异无统计学意义(P>0.05)。超声检查粉碎型鼻骨骨折检出率与CT相近,单纯线型鼻骨骨折超声检出率较高。结论高频超声是实时、快速有效的影像学检查方法,可作为鼻骨骨折首选无创、无辐射的检查方法,值得临床推广应用。
Objective To investigate the comparative analysis of high frequency ultrasound and CT examination of nasal bone fracture in order to improve the ultrasonic diagnosis of nasal bone fracture. Methods From January 2015 to March 2017, 154 cases of suspected closed nasal fracture with a history of trauma were admitted to the Department of Otorhinolaryngology, Longgang District, Shenzhen, including 97 males and 57 females, aged 14-54 years, with a median age of 35.9 year old. CT scans as a reference, retrospective analysis of closed nasal fracture in patients with ultrasound image features that nasal bone fracture is divided into linear fracture, comminuted fracture, complex fracture, incomplete fracture and other four types of ultrasonography features. Results Among the 154 patients with nasal fracture, 53 were simple line CT, 39 were comminuted, 45 were complex, 7 were incomplete and 10 were not found. Ultrasonography was performed on 67 cases of simple linear fracture , 42 cases of comminuted fractures, 18 cases of complex fractures, 13 cases of incomplete fractures, and 14 cases of fractures were not found. There was no significant difference in the diagnostic positive rate between ultrasound and CT (P> 0.05). Ultrasonic examination of broken nasal bone fracture detection rate is similar to CT, simple linear nasal bone fracture ultrasound detection rate higher. Conclusion High-frequency ultrasound is a real-time, rapid and effective imaging method. It can be used as the first choice of non-invasive and radiation-free examination of nasal bone fractures, which is worthy of clinical application.