多层螺旋CT及后处理技术在观察骨折金属内固定器中的应用价值

The Application Value of Multi-slice Spiral CT and Post-processing Technology in Observing the Metal Internal Fixator of Fractures

目的寻找一种能够清楚,全面的显示骨折金属内固定器的影像学检查方法,同时对多层螺旋CT(MSCT)后处理技术在显示不同部位骨折金属内固定器中的应用价值进行探讨。方法 37例不同部位的骨折金属内固定术病人,全部行多层螺旋CT横断面扫描,同时对原始图像进行MPR、SSD或VR重建,观察内固定器的显示效果。结果脊柱内固定术6例,骨盆4例,髋关节3例,股骨4例,髌骨1例,胫腓骨8例,踝关节6例,跟骨3例,肘关节2例。37例骨折金属内固定器经横断面扫描及MPR、VR重建均可明确显示,横断面扫描对内固定器的完整性显示欠佳,但可观察某一平面内固定器的情况。MPR法的矢状位与冠状位,对椎体与长骨内固定器显示最为清楚,同时对骨折线及骨痂形成也可明确显示。VR或SSD法显示的内固定器立体、直观,适用于骨盆以及不规则骨金属内固定器的观察。结论多层螺旋CT在以横断面扫描为基础的情况下,结合MPR的矢状位与冠状位、SSD或VR可多方位,多角度显示金属内固定器,为临床提供了一种观察骨折金属内固定器的有效方法。

Objective To find an imaging method to display the metal internal fixator of fractures clearly and comprehensively and to explore the application value of multi- slice spiral CT and post-processing technology in showing the metal internal fixator of different parts of fractures. Methods Thirty-seven patients with different parts of fractures fixed with metal internal fixator underwent ruulti-slice spiral CT scanning. Row data was reconstructed with ruulti-planar reformation （MPR）, shadow surface display （SSD）, and volume renderng （VR） to observe the effect of display. Results 37 cases of internal fixation were clearly displayed by cross-sectional scanning, MPR and VR reconstruction, including 6 cases of spine, 4 cases of pelvis, 3 cases of hip, 4 cases of femur, 1 case of patella, 8 cases of tibia and fibula, 6 cases of ankle, 3 cases of heel and 2 cases of elbow. Cross-sectional scanning showed poor in the integrity of the internal fixator , but could observe the situation in a plane. The sagittal and coronary view of MPR showed most clearly for the vertebral and long bone fixator, and displayed the fracture line and callus formation defnitely. VR or SSD method showed the internal fixator stereoscopically and intuitively, and applied to observe pelvis and irregular bones fixator. Conclusion Multi-slice spiral CT based on the cross-sectional scan, combined with MPR of sagittal and coronary view, SSD and Vlk, could be all-round, ruulti-angle to display the metal internal fixator and provided an effective method to observe fractures with metal internal fixator for clinical.