多层螺旋CT多平面重建及三维重建在肩胛骨骨折中的应用

Multi-slice spiral CT MPR and 3D reconstructions in the diagnosis of scapular fracture

目的探讨多层螺旋CT(Multi-slice Spiral CT,MSCT)多平面重建和三维重建技术在肩胛骨骨折中的应用及临床价值。方法26例肩胛骨骨折病人行MSCT扫描,图像经工作站处理后进行多平面重建和三维重建,由三位有经验的放射科医师共同阅片分析,统一评定。结果本组26例均可以通过多平面重建和三维重建明确判断骨折情况。其中发现肩胛骨体部骨折18处,肩胛颈骨折8处,盂缘骨折9处,盂窝骨折5处,肩峰骨折11处,肩胛冈骨折4处,喙突骨折3处;同时合并肩关节脱位6例,合并锁骨骨折7例,合并多发肋骨骨折13例。多平面重建可多方位更全面地显示肩胛骨骨折的情况,三维重建能立体形象地显示肩胛骨骨折的范围和方向。结论多层螺旋CT多平面重建及三维重建技术能清晰、直观地显示肩胛骨骨折情况,有利于临床诊断及治疗方案的确定。

Objective To investigatye reconstruction （MPR） and three dimensional （3D） MSCT （Multi-slice Spiral CT）nmlti-plamar reconstructions in the diagnosis of scapular fracture. Methods 26 patients with scapular fracture were examined with MSCT by using imaging post-process of MPR, 3D-VR and 3D-SSD technique. Results In the 26 cases, all can be clearly diagnosed by MPR and 3D reconstructions. The patients were classified according to the method introduced by Hardegger. There were 18 cases with fractures of scapula body, 8 cases with fractures of scapula neck, 9 cases with fractures of glenoidrim, 5 cases with fractures of glenoid cavity, 11 cases with fractures of acromion, 4 cases with fractures of scapula spine, 3 cases with fractures of coracoid process,7 cases with fractures of clavicle, 13 cases with multiple fractures of rib and 6 cases with shoulder joint dislocation. MPR demonstrated the extent better than axial CT, whereas 3D-VR and 3D-SSD images showed more exactly extent and direction than that others. Conclusion MSCT MPR and 3D reconstructions can directly and comprehensively demonstrate the features of Scapula Fracture, which is very helpful for the surgeons in making the therapeutic project.