颌面部骨折的CT扫描和三维重建

The Value of CT Scan and Three-Dimension Reconstruction in Maxillofacial Fracture

目的：比较三维影像（３Ｄ）和二维影像（２Ｄ）在颌面部骨折诊断中的准确性并探讨３Ｄ影像的临床价值。材料与方法：对临床诊断有骨折的３１例颌面部外伤患者进行ＣＴ薄层扫描和３Ｄ重建。结果：３Ｄ影像显示骨折线的走行方向、骨折范围、位置、类型及骨折块的移位等空间信息方面优于２Ｄ影像，３Ｄ对临床处理起着较明确的指导作用。但２Ｄ在发现细小骨折、深部结构骨折及骨壁菲薄处的骨折等方面优于３Ｄ。且３Ｄ影像是在２Ｄ影像的基础上重建的。结论：３Ｄ影像对骨折的畸形表现等空间关系上具有优势，其临床价值大于２Ｄ。但２Ｄ影像仍是诊断颌面部骨折可靠的和基本的方式，两者结合应用。

Objective: To compare the diagnositic accuracy of three-dimensional (3D) CT with conventional two-dimensional (2D) CT in facial fracture and to discuss the clinical usefulness of 3D to surgeons.Materials and Methods:31 trauma patients suspected of having facial fractures were examined with thin-slice CT scan and 3D reconstruction.Results:3D CT provided superior definition of the fracture line courses, number, size and the space informations of fracture fragments displacement. Patients managment was influenced more by 3D CT than by 2D. But 2D image was more accurately in define the tiny fracture and fracture of deep structures, maxillary sinus wall. 2D image is the basis of 3D image.Conclusions: 3D images have advantages in demonstrating space relationships of facial fractures and have higher clinical value than 2D images. But 2D images is still the most accurately and basically diagnostic method for facial fracture. Combination of 2D and 3D image is the best method for maxillofacial fracture.