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The diagnostic value of magnetic resonance imaging in rib micro-fractures
ZHANG Tao  WANG Shuwen  CHEN Yuchen  MAO Cunnan  WU Jing  WU Xinying  YIN Xindao  LU Lingquan 

Cite this article as: Zhang T, Wang SW, Chen YC, et al. The diagnostic value of magnetic resonance imaging in rib micro-fractures[J]. Chin J Magn Reson Imaging, 2022, 13(3): 87-90, 92. DOI:10.12015/issn.1674-8034.2022.03.018.


[Abstract] Objective To explore the value of MRI in the diagnosis of rib micro-fractures through a comparative study of MRI and CT.Materials and Methods Twenty-five patients with mild chest trauma admitted to our hospital from February 2019 to December 2020 were recruited. The patients were subjected to CT and MRI within three weeks after the trauma, CT rescanning was scheduled 4-8 weeks later to classify rib fractures and determine the diagnostic accuracy and sensitivity of MRI and CT for rib micro-fractures. Fisher's exact probability method was used to test the difference between MRI and first CT.Results The rib micro-fractures were divided into two types. Type Ⅰ rib fractures showed cortical fracture with callus formation, whereas type Ⅱ had an intact cortical bone with intraosseous callus formation. Type Ⅰ fracture showed bone marrow edema with subperiosteal effusion in MRI, whereas type Ⅱ showed bone marrow edema without subperiosteal effusion. Ninety-one rib micro-fractures were confirmed by CT rescanning, of which 86 (94.51%) were type Ⅰ fractures and 5 (5.49%) were type Ⅱ. MRI identified 90 fractures, of which 3 were false positive, with the diagnostic accuracy rate of 92.55% and sensitivity rate of 95.60%. Among them, type Ⅰ fractures (n=85, 3 were false positive) showed "sandwich" sign (heterogeneous high-signal shadow within bone marrow of the inner layer, low-signal bony cortex of the middle layer, and high-signal subperiosteal effusion of the outer layer) in fat pressing sequences; type Ⅱ fractures (n=5) displayed intramedullar high-signal intensities and no subperiosteal effusion. Fifty-five fractures (all type Ⅰ) were discovered in the initial CT examination, and corresponding diagnostic accuracy rate and sensitivity rate were 60.44%. There was significant difference in the number of fractures detected by MRI and initial CT (P=0.027).Conclusions MRI has high sensitivity and accuracy in the diagnosis of rib micro-fractures, so it can be used as a routine supplementary examination besides CT for patients with mild chest trauma.
[Keywords] magnetic resonance imaging;computed tomography;rib fracture;oblique-axial;diagnostic value

ZHANG Tao   WANG Shuwen   CHEN Yuchen   MAO Cunnan   WU Jing   WU Xinying   YIN Xindao   LU Lingquan*  

Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

Lu LQ, E-mail: njllq333@sina.com

Conflicts of interest   None.

Received  2021-09-03
Accepted  2022-03-01
DOI: 10.12015/issn.1674-8034.2022.03.018
Cite this article as: Zhang T, Wang SW, Chen YC, et al. The diagnostic value of magnetic resonance imaging in rib micro-fractures[J]. Chin J Magn Reson Imaging, 2022, 13(3): 87-90, 92.DOI:10.12015/issn.1674-8034.2022.03.018

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