多层螺旋CT后处理技术在胫骨平台骨折诊断中的应用价值

The value of postprocessing technique on multi-slice spiral CT in diagnosing tibial plateau fractures

目的探讨多层螺旋CT(MSCT)三维重建(3D)和多平面重建(MPR)在胫骨平台骨折中的临床应用价值。方法 37例胫骨平台骨折患者行MSCT扫描后,将原始图像进行多平面重组(MPR)、最大密度投影(MIP)、容积再现法(VRT)等图像后处理,分析各图像显示骨折情况的能力,并与手术结果对照。结果 37例胫骨平台骨折中,累及外侧平台9例,累及内侧平台6例,累及整个平台12例,平台中线髁间隆突或前、后边缘骨折10例。X线平片漏诊4例,CT更正X线分型2例。MPR重建可显示骨折内部的情况和平台塌陷的程度。3D重建可直观显示胫骨平台骨折线的立体走向、关节面碎裂程度以及平台塌陷的范围。结论 3D和MPR能够准确的测量胫骨平台骨折的劈裂和塌陷的程度,有助于胫骨平台骨折的分型,可为临床医生选择合理的治疗方案提供可靠依据。

Objective To probe value of multi-slice spiral CT （MSCT） three-dimensional （3D） and multiple planar re construction （MPR） reconstruction in diagnosis and treatment of tibial plateau fractures. Methods MSCT was performed in 37 patients of tibial plateau fractures. The raw data of all these cases were processed respectively by kinds of image reconstruction, including multiple planar reconstruction （MPR）, maximum intensity projection （MIP） and volume rendering technique （VRT）. Results Among 37 cases of tibial plateau fractures, 9 cases belonged to the lateral plateau fracture, 6 cases of medial plateau fracture, 12 cases of total plateau fracture, 10 showed fractures in anterior and posterior edge of the plateau midline. 4 cases of fractures were omitted by X-ray plain film, 2 cases typed by X-ray plain film were corrected by findings from CT. MPR is able to show interior situation of fractures and extent of collapse of plateau. 3D reconstruc- tion can clearly display stereoanatomy of fracture line, broken articular surface and scope of collapse of the plateau. Conclusion 3D and MPR help to classify fractures in tibial plateau and to precisely measure erackes and collapses, contribu ting to planning a rational treatment.