16层螺旋CT在足、腕骨病变诊断中的临床应用

Clinical Application of 16-slice Spiral CT in the Diagnosis of Diseases of Foot and Wrist

目的:探讨16层螺旋CT及其三维重建(3D)与多平面重组(MPR)在足、腕骨病变诊断中的临床应用价值。方法:32例足、腕骨病例均采用16层螺旋CT进行扫描,在工作站上进行3D及MPR影像后处理,并对结果进行比较和综合分析。结果:32例病例中正常足骨5例,腕骨3例,拇指外翻畸形2例,跟骨粉碎性骨折后致慢性骨髓炎,骨质疏松2例,距骨骨折5例,舟月骨骨折并月骨缺血性坏死1例,跟骨结核6例,腕骨骨髓炎、骨质疏松3例,跟骨粉碎性骨折5例。16层螺旋CT的3D图像可清晰显示正常小关节及其病变的立体形态,MPR图像则可以多平面多角度地观察骨关节的大小、形态、密度等的改变,对病变显示满意。结论:多层螺旋CT重建能提供骨关节病变非常有价值的空间关系信息,其表现接近病理解剖,临床应用价值大,有利于临床医师选择治疗方案、制订手术计划。

Objective：To evaluate the value of 16-slice spiral CT（SCT） with 3-dimensional （3D） reconstruction and multiplanar reformation（ MPR） in the diagnosis of diseases of foot and wrist. Methods： Thirty-two patients with suspected diseases of foot and wrist underwent 16-slice SCT. Images obtained with postprocessing techniques including 3D reconstruction and MPR performed on a workstation for each case were reviewed. Results： SCT revealed 5 normal feet and 3 normal wrists, 2 cases of hallux valgus, 2 cases of chronic osteomyelitis with osteoporosis complicating comminuted fracture of calcaneus, 5 cases of fractures of talus, 1 case of carpal scaphoid and lunate fracture complicating lunate avascular necrosis, 6 cases of tuberculosis of calcaneus,3 cases of chronic osteomyelitis complicated with osteoporosis of carpal bones, 5 cases of comminuted fracture of calcancus. 16-slice SCT with 3D reconstruction demonstrated stereoscopic morphology of normal and lesions clearly while MPR correctly demonstrated details and density, shape and size of lesions. Conclusion：Sixteen-slice SCT with 3D and MPR techniques can provide valuable spatial information of diseases in bones and joints of wrist and foot which correlated well with that of pathological anatomy.