MSCT三维重建及多平面重建技术在骨关节创伤中的临床应用价值

日的 探讨MSCT三维3D重建技术及多平面重建（MPR）技术在骨关节创伤中的诊断价值。方法 收集全身各部位骨关节创伤患者的CT影像学资料50例，行MSCT薄层横断面扫描，将扫描数据经3D及MPR重建，3例行CT内窥镜（CTVE）观察。结果 50例骨折患者包括颌面骨骨折5例，肋骨骨折10例，四肢骨骨折14例，椎体及附件骨折16例，骨盆骨折5例。重建图像中，3D可以显示骨折和脱位的立体形态，但对微小骨折的显示不如横断面图像，1例鼻骨微小骨折未见显示；MPR图像可行任意方向、任意角度重建，以最佳视角显示骨折及周围软组织情况；3例椎管CTVE可以很好显示骨折片后移造成椎管狭窄程度。结论 MSCT3D及MPR图像结合横断面图像可以提高骨关节创伤的诊断准确率，同时CTVE以内窥镜角度观察椎管狭窄程度，为临床判断伤势及手术治疗提供更多的信息。

Diagnostic value of MSCT 3D and multiplanar reconstruction for trauma of bones and joints

Objective To evaluate diagnostic value of MSCT 3D and multiplanar reconstruc- tion (MPR) for trauma of bones and joints. Methods 50 patients with fracture and/or dislocation underwent MSCT thin slice volume scan. Data collected from scan were recon- structed with 3D or MPR method. 3 patients were observed with CTVE. Results Fractures of 50 patients were situated in facial bones (5 patients), ribs (10), limbs (14), vertebral body and appendix (16) and pelvis (5). 3D reconstruction was able to display stereo anatomy of fractures or dislocation, but was inferior to cross-sectional imaging in showing tiny fractures, failing to display a tiny fracture occurring in nasal bone. MPR was capable of reconstruct images in any direction and with any angle, offering anatomy of fracture and its surroundings with an optimum view angle. CTVE preferably showed extent of narrowed vertebral canal that was caused by rear-shifting fracture slice. Conclusion MSCT 3D and MPR reconstructions help to improve correctness of diagnosis of trauma of bones and joints, and CTVE is able to observe narrowness of vertebral canal with an endoscopic angle, offering more information for assessing trauma and conducing surgical treatment.