螺旋CT重建技术在骨盆骨折中的临床应用

Spiral CT reconstruction in the clinical application of pelvic fractures

目的探讨螺旋CT多平面重建(MPR)、三维表面遮盖法重建(SSD)及容积重建技术(VRT)在骨盆骨折诊断中的价值。方法对33例髋关节骨折及l5例骨盆骨折患者利用采用Philips Brilliance Power MX16排螺旋CT机对48例患者进行了螺旋CT扫描,在Philips Warkstation工作站采用SSD、MPR及VRT作三维重建,并与传统X线平片作比较。结果螺旋CT重建技术均能清晰地显示骨盆骨折的部位、程度及骨盆环破坏情况,而传统X线照片诊断正确才39例。MPR、SSD、VR显示20例复杂髋臼骨折及12例股骨头脱位及X线不能发现的关节腔内碎片和股骨头凹陷性骨折7例。螺旋CT扫描还诊断合并腹部闭合伤4例。结论螺旋CT重建技术较X线平片优势十分明显,能够在立体空间清晰地显示复杂骨折的细节及内脏组织的损伤,对骨盆骨折的临床分型与治疗也具有重要指导意义,应作为常规检查手段。

Objective：To evaluate spiral CT multiple planar reconstruction（MPR）, surface shaded display（SSD）and volume rendering technique（VRT）in the diagnosis of the value of pelvic fracture.Methods：In 33 cases of hip fracture and L5 cases of pelvic fracture patients by using Philips Brilliance Power MX16 spiral CT of 48 patients underwentspiral CT scanning in Philips Warkstation reconstruction,andcomparedwithconventional X-ray.Results：Three dimensional reconstruction workstation using SSD,MPR and VRT three dimensional reconstruction and compared with conventional technique of spiral CT can clearly show the location and degree of fracture of pelvis and pelvic ring damage,while the traditional X-ray pictures of 39 cases were correctly diagnosed.MPR, SSD, VR showed 20 cases of complex acetabular fractures and 12 cases of dislocation of femoral head;X-ray cannot discover and depressed fracture of femoral head in 7 cases.Spiral CT scan in diagnosis of closed abdominal injury alsomerged in 4 cases.Conclusion：Spiral CT three-dimensional reconstruction technique than X-ray plain film has significant advantages, can clearly show all the details of complex fracture in the three-dimensional space, has the important guiding significance to the clinical diagnosis and treatment of pelvic fracture, conventional means should be used as a preoperative examination.