多层螺旋CT及其后处理技术对隐匿性骨折的诊断价值

The Value of Postprocessing Technique with Multi-sliceHelical CT in Diagnosis of the Occult Fracture

目的 探讨多层螺旋CT(MSCT)二维(MPR、MIP)和三维(VRT、SSD)重建技术对复杂结构的隐匿性骨折的诊断价值。资料与方法 对4 2例外伤患者普通X线平片中未显示而临床怀疑有骨折的患者进行MSCT扫描后,通过特殊的CT图像处理软件包在工作站上进行后处理(MPR、MIP、VRT及SSD) ,得到外伤部位骨骼高清晰度的二维和三维图像后,由两位有经验的放射科医师共同阅片,以共同意见为准。结果 4 2例X线平片中未显示骨折的患者经MSCT重建后,18例显示有骨折,其中枕骨骨折2例,肩胛骨骨折2例,肋骨骨折4例,脊椎骨折3例,骨盆骨折3例,股骨颈骨折3例,跟骨骨折1例。结论 MSCT二维和三维重建对临床怀疑骨折而普通X线不能确诊为骨折的病例能准确地作出诊断,并对治疗方案的选择及预后的估计有重要价值。

Objective To evaluate the value of multi slice helical CT 2D and 3D reconstruction for the occult fracture of complicated structure.Materials and Methods 42 patients who were suspicious of fracture but negative on plain X ray film were performed with Multiplanar reconstruction (MPR), maximum intensity projection (MIP), volume rendering technique (VRT) and surface shaded display (SSD) in work station. High resolution 2D and 3D images of the injuried bone were obtained by using a specific CT postprocessing software package, then the images were analyzed by two experienced radiologists to come to a consensus whether there was a fracture or not.Results In 42 injuried patients, 18 patients had fractures in different parts, in which 2 cases were involved in occipital, 2 cases in scapula, 4 cases in rib, 3 cases in vertebra, 3 cases in pelvis, 3 cases in the neck of the femur and 1 case in calcaneus.Conclusion MSCT 2D and 3D reconstruction can be used to diagnose definitely in occult fracture, and play an important role in selecting therapy project and evaluating prognosis.