多排CT曲面重建在颌骨病变诊断与治疗中的评价

Evaluation of CPR image using multislice CT in diagnosis and treatment of jaw disease

目的:利用多排CT扫描后可行上、下颌骨全景曲面重建的特点,探讨多排CT曲面全景片对颌骨疾病的诊断价值及指导临床手术的应用价值。方法:自2002.3.以来,对29例上、下颌骨疾病(包括上、下颌骨囊肿22例、颌骨骨髓炎2例、牙龈癌5例)行16排螺旋CT扫描,扫描层厚0.625mm或1.25mm,将扫描数据传至工作站(GE公司advantageworkstation,AW4.0),对上、下颌骨行不同层面的曲面断层重建,贮存图像并对图像进行分析。同时用X光机拍摄口腔全景片,将二种全景片进行阅片对比。结果:多排CT曲面断层全景片清晰,能清楚显示骨质的细微变化、骨病变的范围及其与周围组织及器官(如牙齿、上颌窦、下齿槽神经管)的关系,无颊舌侧骨组织覆盖影,其图像对疾病的定性诊断具有明确的指导价值,而X线口腔全景片有影像失真,在病变处存在颊舌侧骨质相互重叠影。结论:多排CT口腔全景断层片能非常清晰地显示骨病变与周围组织及牙齿的关系,可显示骨质的细微变化,无放大失真,对颌骨病变的定性诊断、病变范围的界定结果可靠。对临床医师在疾病的诊断,术前手术方案的制订有重要的指导价值。

Objective： To study the value of curved planar reformation image in diagnosis and treatment of jaw lesion using muhislice helical CT. Method：A 16-slice helical CT scanner was used to examine 29 cases of jaw diseases, including cyst of maxilla and mandible, osteomyelitis, carcinoma of gingiva. Data were input into a reconstruction workstation（GE company＇s production： advantage workstation, version 4.0）to create curved planar reformation image, these images analysed and depicted till diagnosis were made. meanwhile, panoramic radiograph were gotten using X-ray machine. Then, these two group images were compared with each other to find differences, Result： Panoramic image taken by multislice helical CT can clearly display the imperceptible change of bone, clearly display the dimension of jaw lesion, the relationship of lesion to the surrounding structure. These results were similar to those obtained through actual operation, whereas panoramic radiograph present vague image and with distortion due to bone overlapping. Conclusion： Curved planar reformation image of multislice CT has competence to create very clear images of jaw disease. It is reliable to provide detailed information for diagnosis and surgical planning.