螺旋CT对骨性泪道骨折的诊断价值

Diagnostic Value of Spiral CT in Bony Lacrimal Passage Fracture

目的:探讨16层螺旋CT在骨性泪道骨折诊断中的应用价值。方法:回顾分析经临床证实的65例骨性泪道骨折患者的16层螺旋CT图像。采用美国GE公司AW4.1工作站对图像进行后处理,行多平面重建术(MPR),比较薄层横断面与多平面重组图像的诊断结果。结果:16层螺旋CT图像能清晰显示泪囊窝、鼻泪管骨折,65例患者共计75处骨折,均为复合性骨折,多为鼻眶筛区域骨折,其中上颌骨额突骨折45例(70%),泪骨骨折30例(46%),伴发筛板骨折40例(62%),鼻骨骨折32例(49%),额骨鼻突骨折13例(20%),鼻颌缝分离23例(36%),鼻额缝分离17例(26%),额颌缝分离20例(30%),泪颌缝分离50例(78%),鼻骨间缝分离26例(40%)。薄层横断面与多平面重组图像对骨性泪道骨折的诊断准确性无显著差异。结论:16层螺旋CT能准确、细致地显示骨性泪道骨折的部位、程度及伴发改变。

Objective：To explore the clinical value of 16-slice spiral CT in diagnosing bony lacrimal passage fracture.Methods：16-slice spiral CT images of 65 patients,which were clinically proved as bony lacrimal passage fractures,were analyzed retrospectively.Postprocessing of images was performed by GE AW4.1.Multi planar reconstruction（MPR）.The thin-thick axial images were compared with the MPR.Results：16-slice spiral CT showed clearly the fractures of lacrimal sac fossa and nasolacrimal duct.All the 65 cases were compound fracture,most of which were naso-orbital-ethmoid fracture,including 45 cases of fractures of the frontal process of the maxilla,30 cases of the lacrimal bone fractures,40 cases of ethmoid bone fractures on the medial orbital wall,32 cases of nasal bone fractures,13 cases of the nasal process fractures of frontal bone,23 cases with nasomaxillary suture separations,17 cases with naso-frontal suture separations,20 cases with frontal-maxillary suture separations,50 cases with lacrimo-maxillary suture separations,26 cases with internasal suture separations.There was no significant difference between the thin-thick axial images and the MPR in diagnosing bony lacrimal passage fracture.Conclusions：16-slice spiral CT can accurately display the location,extent and secondary changes of bony lacrimal passage fracture in detail.