髋臼骨折CT扫描临床应用价值

Clinical Application of CT Scanning for Fracture of Acetabulum

通过分析髋臼骨折 CT及三维重建表现 ,探讨其临床应用价值。 2 5例髋臼骨折均摄 X线平片及 CT横断扫描 ,其中15例采用 MPR(多平面重建 )技术作三维重建。分析 2 5例髋臼骨折的横断及三维重建 CT表现 ,根据 L etournel分型将其分类 ,重点探讨三维重建的应用价值。结果发现 :2 5例髋臼骨折中 ,1简单骨折 10例 ,其中前壁骨折 3例 ,前柱骨折 2例 ,后壁骨折 3例 ,后柱骨折 1例 ,横行骨折 1例 ,X线平片仅显示 8例骨折 ;2复杂骨折 15例 ,其中双柱骨折 4例 ,T型骨折 3例 ,后柱伴后壁骨折 4例 ,前柱伴后半横行骨折 2例 ,横行伴后壁骨折 2例。CT横断扫描共显示关节腔内骨折碎片 18块 ,X线平片仅显示关节腔内骨折碎片 12块 ,并清楚显示软组织损伤情况。三维重建图像多角度显示骨折及移位情况。结论 :髋臼骨折 CT扫描能准确对骨折分型 ,三维重建可弥补横断影像的不足 。

This paper discusses the application value of CT and 3D reconstruction for acetabulum fracture by evaluating their manifestations. In this article, 25 cases of acetabulum fracture underwent both X-ray plain film examination and CT transverse scanning, 15 of them received 3D reconstruction with MPR. The CT transverse and 3D reconstruction manifestations of the 25 acetabulum fractures were analyzed and classified according to the Letournel Classification for further study of application value of 3D reconstruction. As a result, of the 25 fractures, 10 were simple fractures detected by CT including 3 anterior wall fractures, 2 anterior column fractures, 3 posterior wall fractures, 1 posterior column fracture, 1 transverse fracture,with only 8 detected by the X ray plain films; 15 were complicated fractures including 4 anterior and posterior column fractures, 3 T-shaped fractures, 4 posterior column and posterior wall fractures, 2 anterior column and posterior semi-transverse fractures, 2 transverse and posterior wall fractures. CT transverse scans revealed 18 fracture pieces dissociating in the articular cavity, while X ray plain films showed only 12. CT transverse scans could also clearly show the soft tissue injuries from the acetabulum fractures. 3D reconstruction images stood out the factures and malpositions from the different angles. In conclusion, CT scan can produce clear images for accurate classification of acetabulum fractures and 3D reconstruction can make up for the defects of transverse imaging, which provide objective basis for the selection of the therapeutic programs and for the prognosis.