多层面螺旋CT三维重建对脊椎骨折的临床诊断价值研究

The Clinical Value of Multi-slice Spiral CT 3D Reconstructionin in the Diagnosis of Vertebral Fracture

目的探讨多层螺旋CT三维重建在脊椎骨折临床诊断中的价值。方法选取60例外伤性脊柱骨折患者为研究对象,均接受脊椎X线平片、磁共振成像及多层螺旋CT的多平面重建、三维表面重建、容积重建检查。记录并分析各种检查方式对脊椎骨折检出率与骨折位置、骨折类型及合并椎管狭窄诊断准确率的差异。结果60例受试者多层螺旋CT三维重建检查检出全部骨折椎节(100.0%),且骨折位置及合并椎管狭窄诊断准确率均为100.0%,稳定性骨折、爆裂骨折诊断准确率分别为97.2%和95.8%;均显著高于X线平片检查结果(P<0.05),略高于磁共振成像检查结果(P>0.05)。结论多层螺旋CT三维重建技术能有效提高脊椎骨折的检出率及诊断准确性,于患者针对性治疗措施的顺利开展有利。

Objective To investigate the value of multi-slice spiral CT 3D reconstruction in the diagnosis of vertebral fracture. Methods Sixty patients with traumatic vertebral fracture were selected as study subjects. All subjects underwent vertebral X-ray plain film, magnetic resonance imaging and MSCT multiplanar reconstruction,3D surface reconstruction and volume rendering examination. The differences in detection rate of vertebral fracture, accuracy rate in diagnosis of fracture location, fracture types and complication with spinal stenosis among them were recorded and analyzed. Results All fractured vertebral segments in 60 subjects were detected by MSCT 3D reconstruction（100.0%）. The accuracy in diagnosis of fracture location and complication with spinal stenosis was 100.0% while in diagnosis of stable fracture and burst fracture were 97.2% and 95.8% respectively, significantly higher than those of X-ray plain film examination（P〈0.05） and slightly higher than MRI（P〉0.05）. Conclusion MSCT 3D reconstruction technique can effectively improve the detection rate and diagnostic accuracy of vertebral fracture, which is good for the successful implementation of targeted treatment.