关键词: 陈旧性肋骨骨折;容积再现；曲面重建；最大密度投影；司法鉴定

Abstract: Objective To clarity the diagnostic value of thin-slice spiral CT scan and its post-processing function for rib fracture. Methods The subjects were 125 appraised persons aged 41 to 80 who underwent radiographic reexamination of rib fracture in this appraisal institute in 2018. All appraised persons underwent thin-slice spiral CT scanning in this appraisal institute. The diagnosis was made according to the on-site CT imaging examination, and the related data were analyzed by chi-square test. Results Among the cases reviewed by our institute, 64 were inconsistent with the original diagnosis. It is founded that 149 rib fractures were missed. The time span ranged from one month to more than two years after injury. The longer the time, the more difficult it is to detect missed diagnosis. Curved planar reconstruction （CPR）, volume rendering （VR） and maximum intensity projection （MIP） have significant differences in the diagnosis of old rib fractures in different time periods. The detection rate of MIP is the highest, followed by VR and CPR, and the detection rate of each method is the lowest. The difference is statistically significant （P<0.01）. Conclusion Different CT imaging methods have their own advantages for the review of rib fracture at different time after injury.

Key words: forensic clinical medicine；old rib fracture；volume rendering；curved planar reconstruction；maximum intensity projection