螺旋CT三维重建在骨盆后环损伤的应用

Application of three-dimensional CT for posterior pelvic ring fractures

目的探讨螺旋CT三维重建对骨盆后环骨折的诊断及治疗上的临床意义。方法2002年3月～2003年8月,对骨盆骨折且有完整X线平片和CT三维重建资料的19例患者进行回顾性分析,并对两种检查方法的结果进行比较。结果19例患者中,9例X线片漏诊或可疑,经三维CT检查后修正诊断。对于骶髂关节部分及前后分离、骶髂关节内碎骨、骶髂关节髂骨唇或骶骨唇骨折、骶骨骨折及复杂粉碎性的骨盆后环骨折,三维CT较X线片有明显的优势,能多层次清晰显示骨盆后环的骨折形态。结论三维CT检查对骨盆后环骨折的诊断、分类及指导治疗具有重要的意义和作用。

Objective To investigate the clinical significance of three-dimensional CT in diagnosis and treatment of posterior pelvic ring fractures. Methods A retrospective analysis was done for 19 cases of posterior pelvic ring fractures who were treated from March 2002 to August 2003 and had plain and three-dimensional CT films. Their radiological characteristics and results were compared between the 2 kinds of film. Results 3-D CT corrected the misdiaguosis or uncertainty of 9 cases who had plain radio-graphs. The 3-D CT showed obvious advantages over plain radio-graphs in detecting sacroiliac diastasis, sacroiliac joint fragments, fractures involving lilac and sacral lips abutting the sacroiliac joint, sacral fracture and complicated comminuted fracture, because it clearly delineated fractures of posterior pelvic ring and manifested the severity of comminution and separation. Conclusion The 3-D CT scan provides valuable information for precise diagnosis and treatment plan for the complex posterior pelvic ring fractures.