16-MSCT对蝶骨微细骨折的价值研究

Study in Patients with Sphenoid Micro-fractures by 16-MDCT Thin-section Reconstruction Technology

目的：探讨16层螺旋CT（16-MSCT）对外伤性蝶骨微细骨折的诊断价值。方法：随访常规头颅CT检查诊断有可疑蝶骨微细骨折者,于复查时常规5mm层厚螺旋扫描后进行0.625mm、1.25mm、2.5mm及5mm高分辨率骨算法重建（以下简称骨重建）、采集数据完整者61例,结合二维及三维图像进行阅片;按不同层厚计算微细骨折的显示分值及显示率,进行自身对照。结果：61例均查出有微细骨折,每例1~35处不等。分组比较微细骨折的显示率：①0.625mm层厚的显示率为100%;②1.25mm层厚的显示率为89.52%;③2.5mm层厚的显示率为53.33%;④5mm层厚的显示率为30.95%;以上分组比较经统计学（趋势卡方检验）分析,差异均有统计学意义（P〈0.05）可认为扫描层厚与显示效果间存在线性趋势,即层厚越薄显示效果越好。结论：16-MSCT趋于各向同性,在本文研究范围内重建层厚越薄、微细骨折显示越清楚,即0.625mm层厚的微细骨折显示率明显优于1.25mm、2.5mm及5mm层厚。作者认为对可疑蝶骨微细骨折的病例应常规做0.625mm高分辨率骨算法重建,有利于减少蝶骨微细骨折的漏诊,提高诊疗水平,值得推广。

Purpose： To evaluate the value of 16-MSCT in diagnosis of traumatic sphenoid micro-fractures.Methods：Patients with sphenoid fractures,sphenoid sinus hematocele,the gas in out edge of sphenoid were followed up by convention CT inspection.When these patients were undergone follow-up exam,they were adopted the conventional 5mm thin-section helical CT scaning,then 0.625mm、1.25mm、2.5mm and the 5mm high resolution bone algorithm reconstruction were done separately.The data were collected completly in 61 cases.The detection rate of the micro-fractures were calculated.Results：The 61 cases all had micro-fractures.The detection rate of micro-fractures in different groups were as follows：①the 0.625mm thin-section group was 100%,②the 1.25mm was 89.52%,③the 2.5mm was 53.33%,④the 5mm was 30.95%.The group comparison was done by the tendency χ2test,the difference had the statistical significance（P0.05）.Conclusion：In our study,the detection rate of micro-fractures by 0.625mm thin-section reconstruction surpasses 1.25mm、2.5mm and 5mm.It is necessary that patients with suspected sphenoid micro-fractures undergone 0.625mm high resolution bone algorithm reconstruction.It is helpful to reduce the miss-diagnosis rate of sphenoid microfractures.