64排螺旋CT在颌面部外伤的诊断价值

The value of 64 multi-detector spiral CT in the diagnosis of maxillofacial region trauma

目的总结分析说明64排螺旋CT在急诊检查中合理应用多平面重建(MPR)、容积再现(VR)技术的重要性。方法回顾性分析53例颌面部外伤患者的平片、64排螺旋CT多种重建图像,发现MPR、VR在急诊诊断中具有平片及普通CT不可替代的作用。结果 53例经64排螺旋CT扫描重建后所有病例均发现了骨折,其中有5例鼻骨DR侧位平片未见明确骨折者。经MPR重建不仅可以清晰地显示骨折空间移位、重叠程度,而且可以准确地测量出具体数值,而VR可以立体直观地显示出骨折线的走形方向、骨碎片的数目及与邻近组织的空间关系。结论在急诊检查中合理利用64排螺旋CT的各项重建技术不仅可以避免漏诊情况的出现,而且也可以为临床充分了解损伤情况,制定出严谨的治疗方案提供出足够多的影像依据,因此64排螺旋CT重建技术可做为急诊影像检查的常规检查手段。

Objective To illustrate the importance of multi-planar reconstruction （MPR） and volume rendering （VR） in emergency examination with 64 multi-detector helical CT. Methods Through retrospective analysis of plain films and reconstructive images in 53 maxillofacial region trauma, it was found that MPR and VR played an irreplaceable role in emergency examination. Results All the 53 cases had been found fractured through reconstruction of 64 multi-detector spiral CT including 5 nasal bone fracture that had not found by DR. MPR reconstruction not only clearly showed the replacement of fracture and overlapping degree but also accurately measured the values. VR could intuitively show the direction of fracture line, bone chips and the relationships of nearby tissues. Conclusion Rational use of the techniques of image reconstruction for 64 multi-detector helical CT not only avoid misdiagnosis but also provide the clinic with enough image evidences to fully understand the injury and work out a more aggressive care plan for treatment in emergency examination. Thus, the techniques of image reconstruction for 64 multi-detector helical CT can be used as a routine examination in emergency examination of medical imaging.