三维CT影像技术在颌面部骨折中的应用价值分析

Application value of three-dimensional CT imaging technology in maxillofacial fracture

目的分析在颌面部骨折中应用三维CT影像技术的价值。方法68例颌面部骨折患者,先进行螺旋CT平扫检查,之后应用三维CT影像技术检查。以手术结果为金标准,比较两种检查方法的诊断结果,分析不同类型颌面部骨折患者表现特点。结果68例患者经手术确诊骨折85处,其中:上颌骨骨折22处、下颌骨骨折19处、颧骨骨折18处、鼻骨骨折14处、眼眶骨折9处、蝶骨骨折2处、颌关节脱位1处。三维CT影像技术对上颌骨骨折、下颌骨骨折、颧骨骨折、鼻骨骨折检出率分别为100.00%、94.74%、100.00%、100.00%,高于CT平扫的81.82%、68.42%、77.78%、71.43%,差异具有统计学意义(P<0.05);两种检查方法对眼眶骨折、蝶骨骨折、颌关节脱位检出率比较,差异无统计学意义(P>0.05)。Le FortⅠ型骨折:患者骨折线有突出情况,从牙槽突出,并延展至颌翼突缝;Le FortⅡ型骨折:骨折线从鼻额缝向两侧横过鼻梁,颌骨侧壁至颌翼突出,部分患者骨折线突出波及到筛窦达到颅骨前凹陷处,有鼻漏脑脊液情况;Le FortⅢ型骨折:除了有Ⅱ型骨折线表现外,颅面还呈现分离状况,大部分患者伴有颅脑损伤、颅底骨折表现,患者面中部塌陷,多数患者有耳、鼻出血表现。结论将三维CT影像技术应用于颌面部骨折诊断中,骨折检出率高,能够对骨折具体情况进行多角度分析,为患者临床治疗提供可靠、有效、多维度的影像学资料。

Objective To analyze the value of three-dimensional CT imaging technology in maxillofacial fracture.Methods 68 patients with maxillofacial fractures were examined by spiral CT plain scan followed by the application of three-dimensional CT imaging technology.Using the surgical findings as the gold standard,the diagnostic results of the two examination methods were compared,and the performance characteristics of patients with different types of maxillofacial fractures were analyzed.Results 68 patients had 85 surgically confirmed fractures,including:22 maxillary fractures,19 mandibular fractures,18 zygomatic fractures,14 nasal fractures,9 orbital fractures,2 sphenoid fractures,and 1 jaw joint dislocation.The detection rates of three-dimensional CT imaging technology for maxillary fracture,mandibular fracture,zygomatic fracture and nasal fracture were 100.00%,94.74%,100.00%and 100.00%,which was higher than 81.82%,68.42%,77.78%and 71.43%of CT plain scan,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the detection rate of orbital fracture,sphenoid fracture and jaw joint dislocation between the two examination methods(P>0.05).Le Fort typeⅠfracture:the fracture line protrudes from the alveolus and extends to the jaw wing suture;Le Fort typeⅡfracture:the fracture line protrudes from the nasal frontal suture across the nasal bridge on both sides,the lateral wall of the jaw to the jaw wing,and in some patients the fracture line protrudes to the septal sinus and reaches the anterior depression of the skull,with nasal leakage of cerebrospinal fluid;Le Fort typeⅢfracture:in addition to the typeⅡfracture line,the craniofacial surface also shows separation,most patients have craniocerebral injury,skull base fracture,the patient's midface collapses,and most patients have ear and nasal bleeding.Conclusion The application of three-dimensional CT imaging technology in the diagnosis of maxillofacial fracture has high fracture detection rate,which can analyze the specific situation of fracture from multiple angles and provide reliable,effective and multi-dimensional imaging data for clinical treatment.