螺旋CT二维成像与三维重建在颌面部病变诊治中的应用

the value of two-dimensional imaging and three-dimensional reconstruction of spiral CT in maxillofacial lesions

目的 :比较螺旋CT二维成像与三位重建在颌面部病变诊断中的应用效果。方法：选择2011年1月~2013年6月间来我院收治的颌面部外科患者80例,所有患者均采用X线平片、螺旋CT二维成像和三维重建进行影像学诊断,并将螺旋CT重建后诊断结果与二维成像、手术结果进行比较。结果 :在颌面部骨折诊断中,X线平片诊断准确率为75%,螺旋CT二维成像诊断准确率为80%,三维重建诊断准确率为100%。三者诊断骨折准确率比较,三者准确率差异具有统计学意义,且三维重建诊断骨折准确率最高。螺旋CT二维扫面进行颌面部肿瘤诊断,显示其可以准确诊断囊性与实性改变,并能观察病变周围软组织改变;三维CT重建在二维CT的基础可显示骨组织情况、病变周围的结构和相互关系。X线平片与手术结果进行一致性检验,X线平片与手术结果不一致。螺旋CT二维成像与手术结果进行一致性检验,螺旋CT二维成像与手术结果一致。螺旋CT三维重建与手术结果进行一致性检验,螺旋CT三维重建与手术结果一致。结论 :三维重建可反映颌面部病变与周围组织的动态关系和外科操作术野,而且便于引导复杂解剖区域手术的进行,以提高手术质量和降低手术危险,值得临床进一步推广使用。

Objective To explore the value of two dimensional imaging and three- dimensional reconstruction of spiral CT in maxillofacial lesions. Methods Review analysis of the 80 patients for maxillofacial lesions from Jan.2011 to Jun.2013 in our hospital. Compare the results of X-ray, two dimensional imaging and three- dimensional reconstruction and operation. Results Intra - operational findings were consistent with X-ray findings, with the accuracy of 75%. Intra - operational findings were consistent with two dimensional imaging findings, with the accuracy of 80%. Intra - operational findings were consistent with three-dimensional reconstruction findings, with the accuracy of 100%.Compare the accuracy of three ways, χ2=6.384,P<0.05, there were significant differences in the accuracy of three ways, and the accuracy of three- dimensional reconstruction findings was the highest. Two dimensional imaging could show spina bifida cystic and solid of maxillofacial tumors. Consistency check-ing result of X-ray and operation indicated that the results of X-ray and operation were not agree. Consistency checking result of two dimensional imaging and operation indicated that the results of two dimensional imaging and operation were not agree. Consistency checking result of three- dimensional reconstruction and operation indicated that the results of three- dimensional reconstruction and operation were not agree. Conclusion Three-dimensional reconstruction can show the dynamic relationship between maxillofacial lesions and the surrounding tissues, enlarge surgical fields for complex operations, improve peration qual-ity and reduce dangerous, worthy to recommand its clinical use.