齿状突骨折的 CT三维重建分型及临床意义

目的探讨齿状突骨折的CT三维重建分型及临床意义。方法2000年9月～2004年6月,对32例寰枢椎损伤患者均行X线检查、螺旋CT薄层扫描及三维重建检查,评价CT三维重建分型及临床意义。结果X线片检查对齿状突骨折的漏诊率为28.13%(9/32),CT平扫漏诊率为6.25%(2/32),CT三维重建无1例漏诊。结论X线片对齿状突骨折易造成漏诊或诊断不确切。CT三维重建能直观、精确地显示病变的立体形态及各解剖结构的空间关系,提供分型依据,对治疗具有指导作用。

Typing of odontoid fractures based on three-dimensional reconstruction by spiral computed tomography and its clinical significance

Objective To explore the typing of odontoid factures based on three dimensional reconstruction by spiral computed tomography (CT) and its clinical significance. Methods 32 cases of atlantoaxial region injury were examined with X ray plain films, spiral CT scanning and three dimensional reconstruction from September 2000 to June 2004. The CT three dimensional reconstruction was evaluated with respect to its clinical typing significance. Results The rate of misdiagnosis with X ray plain films was 28.13% (9/32). The rate of misdiagnosis with spiral CT scanning was 6.25% (2/32). No diagnosis was missed with CT three dimensional reconstruction. Conclusions X ray plain films often cause misdiagnosis or uncertain diagnosis for fractures of odontoid process. But CT three dimensional reconstruction, which not only displays the stereoscopic shape of the injury region directly and accurately, but also shows spatial relationship of the anatomical details, can provide an accurate basis for the fracture typing and thus guide the treatment. [