256层螺旋CT后处理重建技术在颅骨复杂性骨折及其分型中的诊断价值

The Value of 256-Slice Spiral CT Reconstruction Techniques in Classification and Diagnosis of Skull Complicated Fracture

目的探讨256层螺旋CT后处理重建技术在颅骨复杂性骨折的分型及诊断中的价值。方法收集颅骨外伤首诊CT检查278例,CT扫描层厚1.5mm,层间隔0.75mm,螺距0.39mm,矩阵512×512。影像主要后处理方法:容积再现、最大密度投影、多平面重建、曲面重建。分别采用三种方法进行图像诊断:标准横断面(A方法)、标准横断面+2D重建(B方法)、标准横断面+2D+3D重建(C方法)。结果 278例患者共300处骨折,包括蝶骨33处,筛骨36处,额骨56处,颞骨73处,顶骨61处,枕骨41处;其中线型骨折110处,凹陷型骨折83处,粉碎型骨折107处。三种诊断方法比较,AB间及AC间P<0.05,差异均有统计学意义;而BC间比较,P>0.05,差异没有统计学意义。结论256层螺旋CT的后处理重建技术应用于颅骨复杂性骨折检查,通过多方位多角度观察及综合运用成像方法,可以有效的提高诊断准确率并能清晰的显示骨折的细节。

Objective To investigate the value of 256-slice spiral CT reconstruction techniques in classification and diagnosis of skull complicated fracture..Melhods CT examination were performed in 278 patients ofskuU trauma, with slice thickness of 1.5ram, slice increment of 0.75ram, pitch of 0.39ram and matrix 512 by 512. Image processing methods include volume rendering, maximum intensity projection, multiple planar reconstruction and curved planar reconstruction. Three methods of the image diagnosis were standard axial（A method）, standard axial＋2D reconstruction（B method） and standard axial＋2D＋3D reconstruction（C method）. Results Of the 278 patients with 300 fractures, there were 33 fractures in sphenoid bone, 36 fractures in the ethmoid bone, 56 fractures in the frontal bone, 73 fractures in the temporal bone, 61 fractures in the parietal bone and 41 fractures in the occipital bone, which included 110 linear fractures, 83 pitting type fractures, 107 comminuted fractures. Comparison of three diagnostic methods, the differences were statistically significant （AB and AC P〈0.05）, while the difference was not statistically significant （B and C, P〉0.05）. Conclusion Using 256-slice spiral CT post- processing reconstruction technique in skull complicated fracture, it can improve the diagnostic accurate rate effectively and display the details of the fracture clearly, by means of multi-aspect and different angles observation and comprehensive application of imaging methods.