鼻骨骨折影像诊断的比较研究

Comparative study of three imaging modalities in diagnosing nasal bone fractures

目的通过3种影像学方法的比较,选择合理的鼻部外伤影像学检查方法。方法回顾分析53例鼻骨骨折患者的X线鼻骨侧位像,冠状和横断CT扫描影像资料。以冠状位+横断位CT扫描的结果为准,比较了各种检查方法之间对鼻部外伤影像学征象的检出率。结果冠状位+横断位CT扫描合用的诊断效果最好。X线鼻骨侧位片仅能检出64.15%的鼻骨骨折,对上颌骨额突骨折等其他鼻部外伤均不能诊断。在鼻骨或上颌骨额突骨折的诊断中,冠状位CT扫描显著优于横断位CT扫描,而在鼻泪管骨折,鼻颌缝分离,鼻骨间缝增宽的诊断上则横断位CT扫描显著优于冠状位CT扫描。结论在鼻部外伤的影像学检查中仅利用鼻骨X线侧位片是不够的;为了解有无鼻骨或上颌骨额突骨折应首先作鼻部冠状位CT扫描,如经济条件许可,可加作鼻部横断位扫描。

Objective To select the optimal means in the diagnosis of nasal bone fractures through comparison of three imaging modalities. Methods Fifty-three patients with nasal bone fractures underwent lateral radiography, coronary and axial CT scans of the nose. All imaging data obtained from above three imaging modalities were retrospectively analyzed. The imaging findings of nasal bone fractures on coronary plus axial scanning were taken as a criterion and then the detective rate of nasal trauma or nasal bone fracture by using above three modalities was compared each other. Results The diagnostic efficacy of coronary plus axial CT scanning was the most satisfactory. Lateral radiograply only detected out 64. 15% of nasal bone fractures and did not detect out any fracture of maxillary frontal process or associated trauma of the nose. During diagnosing the fractures of nasal bone or maxillary frontal process, coronary CT scans were significantly superior to axial CT scans, however, during diagnosing the nasolacrimal duct fractures, nasomaxillary raphe separation and internasal raphe widening, axial CT scans were significantly superior to coronary CT scans. Conclusion During the diagnosis of nasal bone fracture or nasal trauma, single lateral radiography is insufficient. In order to demonstrate whether the fractures of nasal bone or miaxillary frontal process are presence, coronaxy CT scanning of the nose should be first selection, if economic condition is allowable, it should be combined with axial CT scanning.