螺旋CT三维重建评价膝关节创伤的临床应用价值

The clinical value of spiral CT with 3D reconstruction in knee joint trauma

目的 :研究螺旋CT三维成像评价膝关节创伤的临床应用价值。方法 :5 5例临床可疑骨折的膝关节创伤者 ,均行X线摄片和螺旋CT三维重建检查 ,由两名以上有经验的放射科医生对图像进行双盲法分析。均经临床随访确诊。螺旋CT扫描范围 5～ 15cm ,扫描层厚 3～ 5mm ,进床速度 6～ 9mm/s,36 0°/s扫描。将原始数据重建为 2～ 3mm层厚 ,1～1 5mm间隔 (重叠率 5 0 % )。将重建后图像传至独立工作站 ,应用多层面容积重建 (MPVR)和表面遮盖显示 (SSD)。结果 :5 5例膝关节创伤病人 ,临床表现或X线平片怀疑骨折 ,最后由螺旋CT及其三维重建发现 35例病人有骨折 ,共 4 5处 ,其中胫骨平台 15例、髁间隆突 12例、股骨内侧髁 7例、腓骨小头 6例、髌骨 5例 ,MPVR和SSD图像结合均提供了准确的影像诊断 ,均清晰地显示了骨折的形状、断端的错位以及碎骨片的分离等情况。结论 :螺旋CT三维重建是膝关节创伤重要的补充检查手段 ,可以进一步证实或排除骨折 ,明显提高了诊断的准确性 ,可以对骨折部位立体、直观地显示 。

Objective:To study the clinical value of spiral CT with 3D reconstruction in knee joint trauma.Methods:55 cases of knee joint trauma suspected to fracture by clinical were examined by plain radiography and spiral CT with 3D reconstruction.The plain film and CT imaging were analysed by two radiologist in double blind method,and the results were confirmed by clinically continuous observation.Spiral scan used 5～15cm range,3～5 mm collimation, 6～9 mm/s and 360°/s speed. Raw data was reconstructed with 2～3 mm thickness and 1～1.5 mm interval (overlap rate 50%), which was sent to work station to be reconstructed with MPVR and SSD techniques.Results:All 55 cases were accurately diagnosed by MPVR and SSD. There are 35 patients with fractures ,in which 45 fractures were found.The shape, displacement of fracture and detached bone fragments were all displayed clearly.Conclusion:Spiral CT, especially with MPVR techniques is an important way to examine the patients with bone and joint trauma who were suspected to have fracture by clinical and plain radiography.