三维重建技术在胸腰椎爆裂骨折中的应用

Helical CT Three-dimensional Reconstruction for Evaluation of Thoracic-lumbar Burst Fractures

目的：探讨螺旋CT三维重建（Three-Dimensioned Reconstruction，3D）技术在胸腰椎爆裂骨折中的诊断及临床应用价值。方法：使用GEHispeed螺旋CT扫描机对87例脊椎损伤患者进行扫描，其中，男63例，女24例；年龄21岁-58岁，平均年龄36岁。全部数据输入Sun Space 20工作站进行三维重建，并与X线平片、二维CT（2DCT）检查结果对照分析，所有图像由两位有经验的影像科医师采用双肓法进行评估。结果：将X线平片、2DCT、3DCT图像资料结合起来进行综合评估所得结果与X线平片合并2DCT图像评估相比较，在显示椎管内骨折片的数量方面，两者差异有显著性（Х^2=4．086，P〈0．05）。多平面重建（Multi—Planar Reconstruction，MPR）能清晰地显示椎管内脊髓受压迫情况。结论：3D技术在胸腰椎爆裂骨折的诊断中具有重要价值，有助于临床医师选择手术方式，减少手术创伤和并发症．

Objective To investigate the clinical value of helical CT three-dimensional reconstruction in diagnosis of thoracic-lumbar burst fractures. Methods 87 patients of spinal fractures, 63 males and 24 females with an average age of 36 years old were examined with GE Hispeed helical CT. All dates were sent to Sun Space 20 workstation. Images were reconstructed in workstation with three-dimensional reconstruction, and then analyzed and compared with X-ray film and 2DCT images. All of images were evaluated by two experienced radiologists with double blind method. Results On 3D images, the occurrence of fractures piece in the vertebral canal was higher than that on X-ray film and 2DCT . There was significant difference between the two groups （Х^2 = 4. 086, P 〈 0.05 ）. Multi-planar reconstruction clearly indicated the spinal cord compression status . Conclusion 3DCT has important value＇in the diagnosis of thoracic-lumbar burst fractures. It is very helpful for the surgeons in the selection of operation method, as well as helpful for reducing operative injuries and complications.