螺旋CT三维成像在骨关节外伤中的应用

APPLICATION OF MULTISLICE SPIRAL CT WITH 3D RECONSTRUCTION IN TRAUMATIC FRACTURES

目的:探讨螺旋CT三维成像在骨关节外伤中的应用。方法:93例外伤骨折患者,均摄X线平片及螺旋CT扫描,在工作站行骨三维重组。结果:颌骨体、颏部骨折X线平片、常规CT和三维成像均清晰显示。三维成像准确显示全部髁状突骨折、颞颌关节脱位,而X线仅显示1例髁状突骨折、1例颞颌关节脱位。肩关节盂及肩胛骨骨折,平片较难显示,常规CT和三维成像均能准确显示。脊柱骨折38例。X线平片能显示骨折的存在,对椎管内的碎骨片或小关节等骨折显示不清。三维成像能立体观察椎体前中后柱及附件骨折,椎管狭窄程度。X线平片对髋臼骨折显示不清,常规CT和三维成像均能显示。结论:X线平片及常规CT仍是判断骨折的可靠手段。三维成像能直观、清楚地显示病变的立体形态及空间关系。

Objective： To assess the usefulness of multislice spiral computed tomography （MSCT） with three dimensional （3D） reconstruction for diagnosing traumatic fractures.Methods： Ninety-three cases with traumatic fracture had undergone 3D-MSCT and plain film , the raw data of MSCT were used to reconstruct bones by shaded surface display and multiple planar reconstruction. The visualization of the reconstructed bones was noted. Results： Bone fractures on the body and mental region of jaw bones were demonstrated clearly on plain film, routine CT and 3D CT imaging. All the fractures of condylar process and dislocation of temporomandibular joint were showed on 3D CT imaging, but only 1 fracture of condylar process and 1 dislocation of temporomandibular joint was showed on plain film. Fractures of cavitas glenoidalis and shoulder blade were showed accurately on routine CT and 3D CT imaging, but they were hardly showed on plain film. In 38 spine fractures, fractures were demonstrated on plain film but the bone chips in vertebral canal and fractures of intervertebral joint were hardly demonstrated. The fractures of vertebral body and accompaniment and the narrow degree of vertebral canal were viewed roundly on 3D CT imaging. Fractures of acetabulum were demonstrated clearly on routine CT and 3D CT imaging but hardly showed on plain film. Conlusion： The plain film and routine CT still remain conventional and dependable for diagnosing traumatic fractures.The three dimensional structure and spatial relation of fractures can be demonstrated clearly on 3D CT imaging.