多层螺旋CT的MPR重建技术在膝关节韧带损伤的应用价值(附20例报告)

Visualization of multi-slice CT using Multiplannar Reformation at Ligament Trauma of Knee Joint(Analysis of 20 Cases)

目的分析多层螺旋CT的MPR重建技术在膝关节韧带损伤中的应用价值。方法20例膝关节外伤患者,男14例,女6例,年龄15-68岁,平均43.6岁。2例累及双侧膝关节,18例为单侧膝关节损伤,共累及22个膝关节,其中左膝关节受累10例,右膝关节受累12例;10例手术(包括1例关节镜),10例保守治疗(1-6个月后复查);对20例的伤后多排螺旋CT的MPR重建图像进行回顾性分析。结果有26条韧带不同程度损伤,单条韧带损伤12例,复合韧带损伤8例,其中韧带挫伤18条,韧带断裂2条,撕裂1条,韧带附着点撕脱5条。膝关节韧带损伤的多排螺旋CT的MPR图像表现为Ⅰ:韧带挫伤:韧带不同程度增粗,肿胀,模糊;Ⅱ:韧带断裂:韧带连续性中断;Ⅲ:韧带附着点撕脱。结论膝关节多排螺旋CT检查对韧带损伤程度、类型的诊断较为准确,但对不完全性韧带断裂诊断有一定困难,对临床治疗指导价值较大。

Objective To evaluate the manifestation and clinical value of the ligament trauma at knee joint on MSCT using multiplannar Reformation. Methods 20 cases （males 14 and female 6, mean age of 43.6 years old, range from 15-68） with 22 knee joint traumas （left 10, right 12） were scanned by 4 slice spiral computed tomography and then the raw data was sent to Vitrea 2 work station to be reconstructed with analyses multiplannar Reformation.（MPR） and volume renderings（VR） etc. Results 26 traumatic ligaments （12single and 8 compound） were found, including 18 contusion, 2 breakdown, 1 tear and 5 avulsion at the point of the ligament attachment. The manifestations of the ligament trauma at knee joint on MSCT are： Ⅰ： swelling and fuggy of the ligament; Ⅱ： breakdown of the ligament; Ⅲ： avulsion at the point of the ligament attachment. Conclusion MSCT could effectively reveal the type and degree of the ligament trauma at knee joint and guide clinical treatment.