螺旋CT多平面重建及三维重建成像在腕关节外伤中的应用

目的探讨螺旋CT多平面重建（MPR）和三维（3D）表面遮盖显示（SSD）在腕关节外伤中的应用价值。方法19例腕关节外伤经X线平片、常规CT扫描、MPR和SSD后处理。结果每例经MPR重建后均能清晰的显示腕关节诸骨骨折及对位关系。SSD能准确评估骨折线的走行和关节对位关系。19例中共发现骨折及脱位51处，其中多发性骨折合并脱位4例，多发性骨折不合并脱位12例，单纯性骨折3例。19例中13例手术结果证实了SSD和MPR显示的骨折及脱位情况，6例手法复位及石膏托固定。结论螺旋CT的MPR和SSD重建有助于腕关节骨折碎片的立体定位和关节脱位分型，对手术方案的制定有重要的临床意义。

Application of 3D reconstruction and MPR after helical CT imaging to wrist trauma

Objective To evaluate efficacy of multiplanar reconstruction (MPR) and surface shaded display (SSD) in helical CT imaging in diagnosing wrist trauma. Methods 19 patients with wrist trauma underwent plain X-ray imaging, routine CT scan, MPR and SSD, depending on which fracture and dislocation of wrist bones were classified into certain groups. Results Reconstruction with MPR was able to display fracture and contraposition in wrist bones, and SSD was capable of indicating direction of fracture line and contraposition of joints. Of 19 cases, fractures and dislocations were found in 51 sites in all, including multiple fractures with dislocation (n = 4), multiple fractures without dislocation (n =12) and simple fractures (n = 3). Operations on 13 patients proved fractures and dislocations that were found by SSD and MPR correct. 6 patients underwent manipulative reduction and plaster support. Conclusion MPR and SSD after helical CT imaging are very helpful for stereoscopic visualization of fragments and accurate classification of wrist fractures and dislocations, playing an important role in the selection of surgical approaches and the evaluation of prognosis.