64层螺旋CT后处理技术在跟骨骨折中的应用研究

An Application Study of 64-Slice Spiral CT Post-Processing Technique in Calcaneal Fracture

目的:探讨64层螺旋CT后处理技术在跟骨骨折中的诊断及临床应用价值,旨在熟练应用各种CT后处理重建技术,为临床手术提供精准的影像信息。方法:收集2016年1月至2018年10月间在苏州市吴中人民医院诊治的跟骨骨折外伤患者60例,所有患者均行西门子64层螺旋CT常规轴扫及薄层重建后处理,包括二维矢状位及冠状位MPR(多平面重建)、三维VR(容积再现)及SSD(表面遮盖显示)。CT轴扫及CT后处理重建技术对跟骨骨折的诊断差异性,使用SPSS17.0统计软件进行卡方检验分析。结果:左侧跟骨骨折25例,右侧跟骨骨折30例,两侧跟骨骨折5例;粉碎性骨折33例,单纯压缩性骨折20例,线性或撕脱性骨折7例;跟距关节内骨折28例,跟距关节外骨折32例。CT轴扫显示粉碎性骨折10例,重建后处理技术显示粉碎性骨折33例,两者比较有显著统计学差异(P <0.01);CT轴扫显示跟距关节内骨折15例,重建后处理技术显示跟距关节内骨折28例,两者比较也有统计学差异(P <0.05)。结论:CT后处理重建技术包括MPR、VR、SSD对跟骨骨折的显示较常规轴扫更细致、精准,能有效评估跟骨骨折的类型,对临床的手术方式选择有很重要的指导意义。

Objective: To explore the value of 64-slice spiral CT post-processing technology in the diagnosis and clinical application of calcaneal fracture, in order to skillfully apply various post-processing and reconstruction techniques of CT, and provide accurate image data for clinical operation. Methods: Sixty cases of calcaneal fracture trauma treated in Wuzhong People's Hospital of Suzhou City from January2016 to October2018 were collected. All patients underwent Siemens 64-slice spiral CT conventional axial scan and thin-slice reconstruction postprocessing, including two-dimensional sagittal and coronal MPR (multi-plane reconstruction), three-dimensional VR (volume rendering) and SSD (surface masking display).The difference of diagnosis of calcaneal fracture between CT conventional axial scan and CT post-processing reconstruction was analyzed by chi-square test with SPSS17.0 statistical software. Results: There were25 cases of left calcaneal fracture and30 cases of right calcaneal fracture;33 cases of comminuted fracture,20 cases of simple compression fracture, 7 cases of linear or avulsion fracture;28 cases of intraarticular calcaneal fracture and32 cases of extraarticular calcaneal fracture;10 cases of comminuted calcaneal fracture on CT axis scan and33 cases of comminuted calcaneal fracture on reconstruction post-processing technology, the difference was significant (P <0.01). There were15 cases of intra- articular calcaneo-talus fracture and28 cases of intra-articular calcaneo-talus fracture showed by post-Reconstruction technique. There was also a statistical difference between the two (P < 0.05). Conclusion: CT post-processing and reconstruction techniques, including MPR, VR and SSD, show calcaneal fractures more carefully and accurately than conventional axial scan, which can effectively evaluate the types of calcaneal fractures and have important guiding significance for the selection of clinical surgical methods.