胸腰椎骨折X线平片螺旋CT三维及多平面重建的对比分析

Comparative analysis between routine plain radiographs,helical CT plain scans,3D and MPR in the detection of thoracolumbar fractures

目的比较和评价X线平片、螺旋CT平扫、三维和多平面重建在胸腰椎骨折诊断中的作用及优势与不足。方法对42例经X线平片、螺旋CT平扫、三维和多平面重建确诊为胸腰椎骨折的病例进行对比分析。结果螺旋CT平扫、三维和多平面重建在显示椎体、椎板、小关节骨折及椎管狭窄方面明显优于X线平片;X线平片、三维和多平面重建在显示椎体压缩、椎体后突成角畸形方面基本一致,但明显优于螺旋CT平扫。结论胸腰椎骨折影像诊断X线平片是基础,CT检查是主要手段,三维和多平面重建是补充,三者结合可详尽反映椎体损伤情况。

Objective To compare the advantages and limitations between routine plain radiographs, helical CT plain scans, 3D and MPR in the detection of thoraeolumbar fractures. Methods Imaging findings of thoracolumbar fractures obtained from routine plain radiographs, helical CT plain scans, three dimensional（3D）and muhiplanar reconstruction（MPR）were analyzed comparatively in 42 eases. Resglts In displaying the fractures of vertebral bodies, vertebral plates and small joints, helical CT plain scanning,3D and MPR were obviously superior to routine plain radiographs. In displaying the compression of vertebral bodies and the angled deformity of vertebral posterior processus, routine plain radiographs, helical CT 3D and MPR were basically coresponding but obviously superior to helical CT plain scanning. Conclusion In the diagnosis of thoracolumbar fractures, routine plain radiograph is a basis, CT is main tool while helical CT 3D and MPR are important supplement. The integration of above 3 modalities can clearly display the details of thoracolumbar injury.