多层螺旋CT及其图像后处理技术在外伤性骨折中的应用价值

The Application in Traumatic Fractures of Multi-slice Spiral CT and Its Image Post Processing Techniques

目的探讨多层螺旋CT横轴位像、MPR、SVR和4D成像在骨关节创伤中的应用价值及相关技术要点。方法选择74例骨关节创伤病人,行X线和四层螺旋CT检查,将螺旋CT扫描容积数据传输至工作站进行MPR和SVR及4D处理,观察骨折细节,并比较X线平片、CT轴位、MPR、SVR和4D之异同。结果在74例患者中,共91处骨折。X线平片准确显示57处,CT综合准确显示91处(其中轴位、MPR、SVR和4D分别显示89、91、81、91处),两者差异有统计学意义(χ2=72.76,P<0.01)。MPR可从任意平面观察骨折及其周围情况,SVR和4D可以显示骨折的立体关系。结论螺旋CT二、三、四维图像在骨关节创伤诊治方面有重要应用价值。特别是对于复杂解剖结构的骨折或复合性骨折更加重要。

Objective To explore the values and the relative key techniques in traumatic changes of bones and joints with axial plane, multiple projection reconstructions, shaded volume reconstructions and transparency X-ray projection of multi-slice spiral CT. Methods There were 74 consecutive patients of trauma in the bones and joints, who where examined by X-ray and multi-slice spiral CT. After that, the volume scanning data were transferred to the work station and processed in multiple projection reconstructions, shaded volume reconstructions and transparency X-ray projection. The observation was focused on the details of the fractures and intercomparison among the X-ray findings with the vizulazition of multi-slice spiral CT. Results In all the patients, the total were 91 sets of fractures. X-ray film could display 57 sets of fractures, while the CT could display 91 sets （ among of them, the axial plane, MPR, SVR and 4D could find 89, 91, 81 and 91 sets individually）. The statistic analysis indicates that there were significant difference between the X-ray film and spiral CT（x^2=72.76, P〈0. 01 ）. MPR delineated the fracture lines and the surrounding changes in arbitrary plane. SVR and 4D resolved the stereotaxic relationship of the fractures. Conclusions Multi-slice spiral CT has an important value in diagnosis of fractures of bones and joints, especially fractures in the complicated structures and multiple fractures.