多层螺旋CT多模式重组在复杂髋臼骨折术前检查中的应用

The preoperative application of multi slice CT with three-dimensional reconstruction in complex acetabular fractures

目的利用多层螺旋CT的容积扫描方法和多平面重建(MPR)、表面遮盖法(SSD)及容积再现(VR)技术,评价其在复杂性髋臼骨折术前检查中的应用价值。方法选取58例患者的损伤髋臼进行多层螺旋CT容积扫描,所得原始数据做数字化三维重组处理,并与常规髋臼CT平扫图像进行对照分析。结果 MPR冠状面、SSD重建结合VR成像,能清晰显示58例髋臼骨折情况,与手术相符,诊断正确率明显高于常规CT平扫。在显示骨折分型、骨折线的长短、形态、走向,骨折片大小、空间位置以及骨折移位程度和关节脱位分类征象方面,2组差异有统计学意义(P<0.05)。结论多层螺旋CT容积扫描和MPR、SSD、VR重组对髋臼骨折具有良好的显示能力,其表现接近病理解剖,是了解复杂骨折类型及其细微结构的理想成像方法。

Objective To evaluate the value of volume scanning method,multiplanar reconstruction（MPR）,surface shaded display（SSD）,and volume reconstruction（VR） techniques in the preoperative examination of complex acetabular fractures. Methods Fifty-eight cases with ancetabular fractures were all accepted CT volume scanning,and MPR were done in all cases. In addition,case-control analysis were done with conventional acetabular CT imagings.Results Coronal plane of MPR,surface shaded display（SSD）combined with VR imaging,could display the acetabular fractures clearly,in accordance with the operations,and its diagnostic accuracy was significantly higher than conventional CT scan. The two sets of data had significances difference（P〈0.05）in displaying fracture type,the length of the fracture lines,the shapes and direction of the fracture,the sizes of fracture pieces,the spatial location,the degree of fracture displacement and the joint dislocation classification. Conclusion Multi slice CT（MSCT） volume scanning,MPR,SSD and VR techniques have good display abilities of acetabular fractures,their performance are close to the pathological anatomy. They are considered to be the ideal imaging methods to know about the complex acetabular fractures and its microscopic structures.