电子束CT三维重建在髋臼骨折诊断与治疗中的应用

Diagnosis of Acetabular Fractures by Three-dimension Reconstruction of EBCT

目的 探讨EBCT (电子束CT)三维重建在髋臼骨折诊断和治疗中的作用。方法 12例髋臼骨折患者均行骨盆平片、EBCT平扫及三维重建检查 ,其中 7例行手术 ,比较以上三种方法的检查及术中情况 ,以显示各自的诊断价值。结果 ①骨盆平片只能显示髋臼骨折 ,不能确定骨折类型。②EBCT平扫可以明确骨折类型 ,但需要阅片者有良好的空间思维能力 ,并熟悉髋臼周围的解剖结构。③EBCT三维重建可以得到髋臼骨折最直观、最全面的图象。结论 骨盆平片诊断髋臼骨折是粗浅的 ,对制定治疗方案帮助有限 ;EBCT平扫能显示骨折的详细情况 ,并由此选择合适的治疗方法 ,但要制定具体的手术方案 ,需要临床医生有丰富的阅片经验 ;EBCT三维重建对制定详细的手术计划可提供正确指导 ,是目前最理想的诊断髋臼骨折的方法。

Objective To probe into the role of EBCT 3D reconstruction in the diagnosis and treatment of acetabular fractures.Methods Twelve patients with acetabular fractures was investigated by plain radiography,axial EBCT and 3D EBCT,7 of whom underwent operative treatment.In order to show the relative merits of above 3 examinations,the results of them and intraoperative views were compared.Results ①The anterio-posterior radiograph of the whole pelvic alone could show acetabular fractures and couldn't classify the type of the fractures.②EBCT scan might identify the type of acetabular fractures and other place fractures of pelvic,but images observer had to have need of good spatial imaginative ability,and proficiently mastered acetabular anatomy.③EBCT 3D reconstruction might gain the most objective and overall image of acetabular fractures.Conclusions The value of the plain radiographs of pelvic was limited in the diagnosis of acetabular fractures and the decision of pre-operative planing.EBCT images could show acetabular fractures in detail.On the basis of EBCT images,rational treatment might be drawed,but working out the detail of operative plan,orthopedist had to have rich experience in observing EBCT scan.The images of EBCT 3D reconstruction might provide exact guidance to formulate operative plan,thus EBCT 3D reconstuction now was the best method in the diagnosis of acetabular fractures.