多层螺旋CT后处理技术应用于四肢骨关节骨折中的影响及意义

Influence and Significance of Multislice Spiral Computed Tomograhpy Post-processing Technology in Extremital Bone and Joint Fractures

目的:探讨多层螺旋CT(MSCT)后处理技术应用于四肢骨关节骨折中的影响及意义。方法:选取2019年1-12月本院收治的四肢骨关节骨折患者178例,所有患者均在本院接受DR片检查与MSCT检查,并将所有患者的MSCT扫描检查数据上传至后处理工作站,实施二维多平面重建(multiplanar reconstruction,MPR)与三维容积再现(volume rendering technique,VRT)。观察DR片、MSCT轴位、二维MPR及三维VRT在诊断骨关节骨折方面的情况,DR片、MSCT轴位、二维MPR及三维VRT在显示关节面损伤方面的情况,DR片、MSCT轴位及MSCT后处理技术在诊断不同骨折分型方面的情况。结果:MSCT轴位、二维MPR及三维VRT在骨关节方面的诊断符合率显著高于DR片(P<0.05);而MSCT轴位、二维MPR及三维VRT三种检查方式比较,差异无统计学意义(P>0.05)。关节面断裂显示方面:二维MPR显著高于MSCT轴位与三维VRT(P<0.05)。关节面塌陷显示方面:二维MPR与三维VRT显著高于DR片与MSCT轴位(P<0.05)。关节内碎骨片显示方面:二维MPR与三维VRT显著高于MSCT轴位和DR片(P<0.05)。关节脱位显示方面:二维MPR与三维VRT显著高于DR片与MSCT轴位(P<0.05)。MSCT后处理技术诊断髋臼骨折分型的符合率显著高于MSCT轴位与DR片(Z=6.152,P<0.05)。MSCT轴位与MSCT后处理技术诊断胫骨平台骨折分型的符合率显著高于DR片(Z=6.958,P<0.05)。结论:四肢骨关节骨折患者使用MSCT后处理技术:二维MPR与三维VRT能对四肢骨关节骨折进行有效的检查与诊断,值得临床应用。

Objective:To explore the influence and significance of multislice spiral computed tomograhpy(MSCT)post-processing technology in extremital bone and joint fractures.Method:From January to December 2019,178 patients with extremital bone and joint fractures were selected.All patients were examined by DR film and MSCT in our hospital.The MSCT scanning data of all patients were uploaded to the post-processing workstation,and the two-dimensional multiplanar reconstruction(MPR)and three-dimensional volume rendering technology(VRT)were implemented.DR film,MSCT axial position,two-dimensional MPR and three-dimensional VRT were observed in the diagnosis of extremital bone and joint fractures.DR film,MSCT axial position,two-dimensional MPR and three-dimensional VRT were used to show the damage of articular surface.The DR film,MSCT axial position and MSCT post-processing technology were observed in the diagnosis of different fracture types.Result:The diagnostic coincidence rates in bone and joint of MSCT axial position,two-dimensional MPR and three-dimensional VRT were higher than that of DR films(P<0.05);while the coincidence rate of three inspection methods of MSCT axial position,two-dimensional MPR and three-dimensional VRT compared,there was no significant difference(P>0.05).The display aspect of articular surface fracture:two-dimensional MPR was significantly higher than those of MSCT axial position and three-dimensional VRT(P<0.05).The display of articular surface collapse:two-dimensional MPR and three-dimensional VRT were significantly higher than those of DR film and MSCT axial position(P<0.05).The display of intra-articular bone fragments:two-dimensional MPR and three-dimensional VRT were significantly higher than those of MSCT axial position and DR films(P<0.05).The display of joint dislocation:two-dimensional MPR and three-dimensional VRT were significantly higher than those of DR film and MSCT axis position(P<0.05).The coincidence rate of MSCT post-processing technology in the diagnosis of acetabular fracture classification was significantly higher than those of MSCT axial position and DR films(Z=6.152,P<0.05).The coincidence rate of MSCT axial position and MSCT post-processing technology in the diagnosis of tibial plateau fracture classification was significantly higher than that of DR film(Z=6.958,P<0.05).Conclusion:MSCT post-processing technology for patients with extremital bone and joint fractures:Two-dimensional MPR and three-dimensional VRT can effectively check and diagnose extremital bone and joint fractures,and are worthy of clinical application.