螺旋CT SSD在颌面部骨折的应用价值

The value of 3D surface shaded display of spiral CT in maxillofacial fracture

目的:探讨螺旋CT扫描及三维表面遮盖成像（SSD）在颌面部骨折的应用价值。方法:对48例颌面部骨折患者行螺旋CT扫描后多平面重组（MPR）及三维表面遮盖成像,并与手术结果对照。结果:单纯上下颌骨折各11例,混合骨折26例。3例眶底骨折,1例上颌面线形骨析,及2例下颌角线形骨折二维来显示或显示欠清晰;SSD有4例细小骨折及深部骨析未能显示。SSD清晰地显示颌面部骨折的类型、位置、范围、骨折块的移位、凹陷程度及不规则骨折线的走行方向。结论:二维影像在显示深部及细小骨折方面优于SSD,但SSD能清晰显示颌面部骨折的立体解各图像及周围组织的关系,为临床提供理想的整复模式,两者应结合使用。

Objective: To evaluate spiral CT three-dimensional (3D) surface shaded display (SSD) in diagnosis of maxillofacial fracture. Methods: 48 cases of maxillofacial fracture were performed spiral CT scanning, then the source images were processed by multiplanar reformation (MPR) and 3D reconstruction. The results were compared with the surgical findings. Results:Simple mandible or maxilla fracture was seen in 11 cases respectively,mixed fracture in 26 cases. 3 cases of orbital floor fracture,One case of linear fracture of maxilla and 2 cases of linear fracture of mandible were not demonstrated or not clearly on two-dimensional (2D) image. Small and deep fracture in 4 cases were not shown on SSD image. SSD image could show the type,position,extent,displacement of the fracture,and the degree of depression,as well as the course of the irregular fracture. Conclusion:2D imaging is superior to 3D image in the demonstration of small and deep fracture, but SSD image can clearly demonstrate three dimensional anatomical relationships of maxillofacial fracture and the relationship of the fracture to adjacent structures. Thus,it is better to combined the use of the two imaging methods.