多层螺旋CT与磁共振成像在细微及隐匿性骨折诊断中的应用

目的探讨多层螺旋CT(MSCT)与磁共振成像(MRI)在细微及隐匿性骨折中的诊断价值。方法对69例车祸伤后,常规X线、普通CT检查阴性,但怀疑有骨折或临床症状明显者行MSCT和MRI检查。结果 MSCT检查发现52例细微骨折,其中鼻骨骨折8例,颅底骨折9例,脊柱骨折6例,肋骨骨折10例、骨关节骨折19例;另17例MSCT检查未见骨折征象,再行MRI检查并诊断为隐匿性骨折,其中脊柱骨折5例,骨关节骨折12例。结论 MSCT检查能发现常规X线与普通CT未能发现的细微骨折,对特殊部位,如颅底、肋骨骨折诊断有明显优势,对骨折的类型、骨折线涉及范围有较准确的诊断;而MRI检查可显示不能被MSCT所发现的骨挫伤及隐匿性骨折。MSCT与MRI联合应用,可为骨折患者的临床治疗及交通事故的医疗鉴定提供可靠的依据。

Application of multislice spiral CT and MR imaging in the diagnosis of fine and occult fractures

Objective To determine the feasibility of multislice spiral CT（MSCT） and magnetic resonance imaging（MRI） for diagnosing the fine and occult fractures.Methods Sixty-nine patients with communication accident trauma initially were negative findings on conventional radiographs and CT images and then underwent MSCT and MRI examinations for suspected fractures.Results Among 69 patients with suspected fracture,MSCT detected out 52 cases fine fractures whose locations included 8 nose,9 cranial bases,6 spines,10 ribs,and 19 bone joints,while other 17 cases without fracture signs on MSCT images further underwent MRI examinations,simultaneously,the occult fractures were found in 5 cases of spine and 12 bone joint,respectively.Conclusion MSCT was able to detect fine and occult fractures which could not be found by either plain radiography or conventional CT,especially it has significant advantage in detecting the fractures in some uncommon locations such as cranial basis and rib and in identifying the type of fractures and the extent of fracture lines,while MRI could show the bone contusions and occult fractures which could not be found by MSCT.The combination of MSCT and MRI can provide the reliable evidence for guiding the clinical treatment and identifying the traffic accident.