64层螺旋CT评价膝关节创伤后的隐匿病变及软组织损伤

Evaluation of the occult lesions and soft tissue injury after knee injury by 64-slice spiral CT

背景:膝关节创伤患者在行X射线检查后进一步选择64层螺旋CT检查时,根据伤情及重建需要选择何种后处理技术在临床上存在一定分歧。目的:探讨64层螺旋CT及后处理技术在膝关节创伤中的应用价值。方法:回顾性分析79例膝关节创伤患者的普通X射线片及64排螺旋CT影像学资料,采用多平面重组、容积显示和表面遮盖显示等后处理技术,结合原始骨窗及软组织窗图像,由2名以上有经验的放射科和骨科医生对图像进行双盲分析并与临床及图像重建结果对照。结果与结论:在79例膝关节创伤患者中,共计92处骨折。普通X射线片诊断68例82处骨折,1例假阳性,5例假阴性,检出率约为89%;经64层螺旋CT及三维重建后确诊79例共92处骨折,检出率100%。证实,和X射线检查相比,64层螺旋CT及多种图像重建是膝关节创伤的重要辅助检查手段,能进一步明确有无膝关节周围隐匿性骨折、微骨折及脱位及软组织损伤等。

BACKGROUND： The patients with knee trauma received the 64-slice spiral CT examination after the X-ray examination, and there still some differences on the choice of the post-processing technology in clinic according to the injury and reconstruction needs. OBJECTIVE： To investigate application value of 64-slice spiral CT and the post-processing technology in the knee injury. METHODS： The imaging data of the X-ray and 64-slice spiral CT of the 79 patients with knee injury were retrospectively analyzed, the post-processing technology, such as the multiple planar reformation, volume rendering and shaded surface display were adopted and combined with the image of the original bone and soft tissue window, and the images were dealt by two or more experienced X-ray and orthopaedic surgeons with double-blind analysis and compared with the clinical and operation results. RESULTS AND CONCLUSION： In all the 79 patients with knee injury, there were a total of 92 fractures. Ordinary X-ray diagnosis showed 68 cases of 82 fractures, except one false positive and five false negative, the detection rate was about 89%; after the 64-slice spiral CT and three-dimensional reconstruction, 79 cases of 92 fractures were diagnosed, the detection rate was 100%. Compared with the X-ray examination, the 64-slice spiral CT and the many kinds of reconstruct technique are important auxiliary examination methods of the knee injury, and they can further identify whether there are secretiveness fracture, micro fractures, dislocation and soft tissue injury around the knee joint.