螺旋CT三维及四维成像在髋臼骨折中的应用

目的：探讨髋臼骨折中三维及四维CT重建技术的方法及临床应用价值。方法：32例髋臼骨折患者进行螺旋CT扫描，并通过多平重建法（MPR），三维表面遮盖法（SSD）及容积重建技术（VRT）观察损伤细节，对骨折进行临床分型。其中11例术后进行内固定复位及关节置换的疗效观察。结果：32例中MPR，SSD显示骨折28例，有4例未显示全部骨折线；SSD显示骨折立体效果优于VRT，对明显移位旋转的骨折显示清晰。VRT显示全部骨折，且在显示骨折细微结构和无移位骨折方面优于SSD，并可立体直观显示术后固定位置及复位效果。结论：螺旋CT，MPR，SSDVRT技术是诊断髋臼骨折的有效手段，对诊断复杂性髋臼骨折应作为首选，VRT技术对髋臼骨折手术方案制定及术手疗效判断有较高的价值。

Application of spiral CT in acetabular fractures

Objective To explore the method and application value of three and four dimensional reconstructive technique of spiral CT in the fracture of acetabulum. Methods Thirty two cases of acetabular fracture were examined with spiral CT, multiplanar reconstruction (MPR), surface shaded display (SSD) and volume rendering technique (VRT) to observe the details of lesion, so as to analyse the fracture. Results The fracture was detected in 28 cases by MPR and SSD, and the whole fracture line was not observed in 4 cases. SSD was superior to VRT in observing the three dimensional status and could show clearly the displacement and rotation. All fracture could be shown by VRT and it was superior to SSD in observing the tiny structure of fractures and undisplacement fractures. VRT could be used to observe directly the post operation statue. Conclusions MPR, SSD and VRT of spiral CT are effective methods to diagnose complex fracture of acetabulum. The technique of VRT is valuable in designing the operative scheme and judging the operation effect.