螺旋CT三维重建在髁突骨折诊断中的应用

目的：应用螺旋CT三维影像重建技术诊断髁突骨折。方法：对28例髁突骨折行螺旋CT扫描检查，作冠状平面与颌面骨三维立体重建，与下颌全景X线片进行对比观察。结果：螺旋CT对28例髁突骨折均可确诊并分类，低、中、高位骨折分别为9、11和8例，全景X线片分别为9、9、4例．剩余2例中位和4例高位骨折漏诊。术后CT复查显示手术复位效果满意。结论：螺旋CT冠状平面重建对中、高位骨折有特殊诊断价值．三维立体重建影像直观地显示了骨折情况，对髁突骨折的诊断、治疗方案的制定和疗效评价有重要作用。下颌全景X线片的诊断作用有限，可用于颌面外伤患者的初步检查。

Clinical application of spiral CT scanning and 3D imaging reconstruction in the diagnosis of mandibular condylar fractures

PURPOSE:To introduce the clinical application of spiral CT scanning and3D imaging reconstruction in the diagnosis and treatment of mandibular condylar fractures.METHODS:28cases with condylar fracture were examined by spiral CT scanning and3D imaging reconstruction were completed.Condylar fractures were classified according to panoramic X-ray film and3D CT imaging.Open reduction and internal fixation were carried out for26cases(34joints)and surgical effect were observed by radiology.RESULTS:All28condylar fractures(36joints)could be clearly diag-nosed by spiral CT and classified as lower(9),middle(11)and high(sagittal)fracture(8),respectively only22cases were diagnosed by panoramic X-ray film and classified as lower(9),middle(9)and high(4),the other6failed to be diagnosed.The effect of surgical reduction was satisfactory by X ray film and spiral CT examination.CONCLUSION:Spiral CT plays a very important role in diagnosis and treatment of condylar fractures,especially coronal reconstruction imaging for high condylar sagittal fractures.3D reconstruction imaging displays the most direct vision to condylar fractures.Panoramic X-ray film has a limited diagnostic valuable and should only be used as a preliminary examination of maxillofacial trau-ma.