膝关节J形征在复发性髌骨脱位患者中的发病率、分度及放射学特征

目的:探究膝关节J形征在复发性髌骨脱位患者中的发病率、分度及放射学特征。方法:对59例连续的复发性髌骨脱位患者进行回顾性分析,根据患者在清醒状态下膝关节近伸直位时的髌骨外侧位移程度,将J形征分为阴性(-)、一度阳性(轻度,1+)、二度阳性(明显,2+)三组。采用膝关节0°位CT量化髌骨外移和外倾程度,参数包括:髌骨平分指数、髌骨滑车距离、髌骨外倾角。结果:入选的59例患者中:72.9%(43/59)存在J形征阳性,其中27.1%(16/59)一度阳性(1+),45.8%(27/59)二度阳性(2+)。3个CT参数均随J形征分度的增加而增大(P<0.05)。结论:在59例连续的复发性髌骨脱位病例中,J形征阳性率为72.9%,J形征的严重程度与髌骨外移和外倾程度呈正相关性。     

成年人高位髌骨的X线改变及临床分析

目的观察成年人高位髌骨患者的X线改变,并根据X线改变进行临床分级,以估计预后和指导临床治疗.方法对临床诊断为高位髌骨的18例成年患者,共计34侧膝关节,进行屈膝30°侧位片和髌骨轴位片的拍摄,然后在X片上测定Blumensaat距离、髌骨高度、股骨滑车沟角、髌股协调角、外侧髌股角、髌股指数、髌骨外移度七项参数,并与对照组进行比较.选用Blumensaat距离,髌骨高度及髌股协调角作为临床分级的参数指标.结果病例组与对照组比较Blumensaat距离,髌骨高度的差异有非常显著性意义(P＜0.01);髌股协调角、外侧髌股角、髌股指数、髌骨外移度的差异有显著性意义(P＜0.05);股骨滑车沟角的差异无显著性意义(P＞0.05).临床分级10侧膝关节属轻度,表现为髌骨软骨软化症,药物疗效好;21侧属重度,表现为髌股关节骨关节炎,药物疗效差.结论成年人高位髌骨的X线改变以髌骨的异常高位为主,伴有一定程度的髌骨外移和向外侧倾斜,临床分级在定性诊断的基础上,融入了定量诊断,有进一步研究的必要性.     

Hoffa病与髌骨运动轨迹异常相关性的MRI研究

目的：探讨Hoffa病与髌骨运动轨迹异常的相关性。方法：回顾性分析46例经MRI证实为髌下脂肪垫水肿的Hoffa病患者（病例组）及28例健康体检者（对照组）的MRI及临床资料。病例组中11例行关节镜治疗及病理学检查。在MRI图像上测量5个髌骨运动轨迹参数,包括股骨滑车深度、股骨滑车与胫骨结节的水平距离（TTTG）、髌骨外移度、外侧髌股角（PFA）和InsallSalvati指数。对这5个指标在病例组和正常组问的差异进行统计学分析。结果：Hoffa病的髌下脂肪垫水肿在脂肪抑制T2WI及PDWI序列上显示清晰,均呈高信号改变。病例组及对照组股骨滑车与胫骨结节的距离（TTTG）、外侧髌股角（PFA）和Insall-Salvati指数间的差异有统计学意义（Z值分别为-2．523、-2．261和-2．812,P值均〈0．05）,两组间滑车深度及髌骨外移度的差异无统计学意义（z值分别为-1．025和-0．111,P值均〉0．05）。病例组内出现髌骨外移度（〉3mm）、外侧髌股角（PFA≤0°）和Insall-Salvati指数（〉1．2）异常者较对照组多,两组间差异有统计学意义（X^2值分别为6．917、5．572和9．582,P值均〈0．05）。结论：Hoffa病的主要MRI表现为髌下脂肪垫水肿,MRI是本病的首选检查方法;Hoffa病与髌骨运动轨迹异常间有相关性。     

术前J形征分度对复发性髌骨脱位术后短期临床结果的影响

目的:探讨对于行内侧髌股韧带(medial patellofemoral ligament,MPFL)重建的复发性髌骨脱位患者,术前髌骨轨迹J形征分度对术后短期临床结果的影响。方法:从2016年1月至2018年12月连续诊断为复发性髌骨脱位的患者中选取符合纳入标准的患者104名,平均手术时年龄为21岁。根据术前髌骨轨迹J形征分度将患者分为Ⅰ度组、Ⅱ度组和Ⅲ度组,术后采用髌骨切线位应力像评估髌骨术后稳定性,同时评估术前及术后Kujala评分,并比较其在上述三组间的差异。结果:Ⅲ度组患者平均股骨前倾角、胫骨外旋角和高位髌骨发生率均大于Ⅰ度组和Ⅱ度组,差异具有统计学意义。所有患者术前平均Kujala评分为54分,术后为86分,差异具有统计学意义。亚组分析结果显示,Ⅲ度组患者的术后Kujala评分低于Ⅰ度组及Ⅱ度组,差异具有统计学意义。股骨前倾角≥30°的患者,其术后Kujala评分低于股骨前倾角<30°的患者,差异具有统计学意义(P=0.023)。随访期间无患者发生髌骨再脱位,但Ⅲ度组中有6人(18.8%)存在术后MPFL残存松弛,而Ⅰ度组和Ⅱ度组均无MPFL残存松弛现象,差异具有统计学意义。结论:对于行单纯MPFL重建或联合胫骨结节内移截骨的复发性髌骨脱位患者,术前III度J形征对术后短期临床结果及髌骨稳定性存在负面影响。股骨前倾角增大、胫骨外旋角增大以及高位髌骨可能是复发性髌骨脱位出现Ⅲ度J形征的危险因素。     

髌骨内外侧支持带损伤MRI表现初步研究

目的增加对髌骨内、外侧支持带损伤MR表现的认识,为治疗前病情评估和治疗方式的选择提供依据。资料与方法回顾性收集经MRI成像及临床证实的34例髌骨内、侧支持带损伤和10例外侧支持带损伤的MRI检查病例,观察内外侧支持带及周围结构损伤MRI表现,并观察内外侧支持带损伤与髌骨脱位的关系。结果 MRI共显示31例内侧髌股韧带损伤,其中3例为中段嵌顿在内侧髌股关节间隙内,未行分级;18例存在髌骨附着处损伤,10例存在股骨附着处损伤。MRI评价I度损伤2例,Ⅱ度损伤21例,伴髌骨半脱位或脱位15例,Ⅲ度损伤5例,全部伴髌骨脱位。同时伴3例内侧髌胫韧带损伤,3例内侧髌骨半月板韧带损伤;10例髌骨外侧支持带损伤,均为横韧带损伤。结论 MRI可很好地显示髌骨内、外侧支持带损伤特点,髌骨易于外脱位主要与髌骨内、外侧支持带的解剖因素有关。     

MRI对复发性髌骨不稳的解剖学危险因素的测量与评估

目的 定量测量并评估复发性髌骨不稳患者的髌股解剖学相关指标及其首要危险预测因素.方法 对52例经保守治疗失败的复发性髌骨不稳的年轻患者患膝进行回顾性MRI图像分析,测量指标包括描述髌骨轨迹的3个参数:髌骨偏移指数(BSO)、滑车适合角(CA)和髌骨倾斜角(PTA)以及描述髌股关节解剖学的7个参数:滑车沟角度(SA)、股骨外侧滑车倾斜角(LTI)、股骨滑车面对称性、股骨滑车深度、ISR(Insall-Salvati Ratio)、C-D(Caton-Deschamps index)和胫骨结节-股骨滑车沟(TT-TG)距离,并对测量结果进行Pearson's相关及多元逐步回归分析.结果 髌骨轨迹异常与LTI、TT-TG距离和ISR均存在显著相关性,而与股骨滑车深度、SA、滑车面对称性及C-D之间无统计学相关性或仅有部分指标相关.解剖学参数LTI、TT-TG距离及ISR构成的回归模型对BSO、CA和PTA的拟合优度R2分别为0.58、0.47和0.43(P<0.001),其中LTI的标准化回归系数β值最大,其次为TT-TG距离和ISR.结论 伸膝位时,MRI定量测量的髌股解剖学相关参数可以一定程度上解释复发性髌骨轨迹的外移和倾斜,其中:LTI是导致髌骨轨迹异常的解剖学相关指标中的首要危险预测因素,其次分别是TT-TG距离及ISR.     

关节镜下评估髌骨轨迹不良严重程度的临床应用研究

目的：探索髌骨轨迹不良严重程度与关节镜下髌骨复位角度的相关性,明确关节镜下评估髌骨轨迹的临床有效性。方法：从2017年1月至2018年12月连续就诊的患者中筛选出复发性髌骨脱位117例。术前采用髌骨J形征和髌骨平分指数（bisect offset index,BOI）评估髌骨轨迹不良的严重程度,术中使用关节镜观察屈伸膝过程中髌骨轨迹的动态变化,记录髌骨复位时的屈膝复位角度（knee flexion angle,KFA）。测量髌骨高度、胫骨结节-股骨滑车沟距离、股骨前倾角等影像学参数。采用Pearson相关分析BOI和KFA之间的相关性。结果：本研究共纳入117例复发性髌骨脱位,平均年龄为21.1±6.7岁,所有患者在镜下均能观察到髌骨轨迹不良。87.2%(102/117)的病例术前J形征阳性,术前BOI平均值为124%。Pearson相关性分析显示BOI和KFA为弱相关,相关系数0.24。不同J形征分度病例的KFA差异无统计学意义。结论：关节镜下评估是一种敏感的髌骨轨迹不良评估方法,但屈膝复位角度（KFA）这一参数与髌骨轨迹不良严重程度仅存在弱相关,KFA无法用于准确量化复发性髌骨脱位...     

关节镜下内侧髌股韧带紧缩增强术治疗青少年髌骨脱位——12例患者至少2.5年随访结果

目的:回顾性研究关节镜下紧缩、增强内侧髌股韧带(medial patellofemoral ligament,MPFL)手术方法治疗青少年髌骨脱位的临床效果。方法:2009年3月~2012年2月,对14例青少年髌骨脱位患者进行关节镜下内侧髌股韧带紧缩增强术治疗。关节镜下用2号Orthocord线经皮下与滑膜外绕行MPFL的髌骨止点下缘与股骨止点上缘,屈膝70°位打结固定,增强MPFL,联合外侧髌骨支持带松解术,矫正髌骨运动轨迹。患者均行Beighton评分、Q角测量、Insall指数测量、恐惧试验、髌骨外移试验、滑车发育不良分级、TT-TG距离测量。采用IKDC评分、Lysholm评分与Tegner评分,调查患者的满意度。结果:12例患者获得随访(3例首次髌骨脱位,术前均有游离体,9例复发性髌骨脱位),IKDC、Lysholm与Tegner评分均有显著提高(P<0.01),83.3%(10/12)患者在术后4~6个月时完全恢复到外伤前运动水平。9例对手术效果非常满意,3例满意。1例患者术后2年因外伤再次髌骨脱位,2例患者术后剧烈运动时出现髌骨不稳,3例术后恐惧试验阳性且髌骨外移试验阳性,无明确抵抗感。Beighton评分5.8±1.9分,Q角14.1°±4.8°,Insall指数1.17±0.13,TT-TG距离12.4±3.8 mm,91.7%的患者存在股骨滑车发育不良。结论:关节镜下MPFL紧缩增强术是一种适合青少年(骨骺未闭者更适合)髌骨脱位患者的、有效、安全、微创的手术方法。对于髌骨脱位的危险因素可以不做过多考虑,本技术也是一种很有价值的过渡性治疗方法。     

MR定量测量指标对复发性髌骨不稳的诊断价值

目的:探讨复发性髌骨不稳的MR定量测量指标在不同性别和年龄段中的差异性及其相应的诊断价值.方法:将54例(58例患膝)经保守治疗失败的临床确诊为复发性髌骨不稳的患者作为髌骨不稳组,另收集53例(53例健膝)无膝关节疼痛、外伤等不适症状的健康人群作为对照组,进行回顾性MRI图像分析.测量指标包括:髌骨偏移指数、髌骨倾斜角、滑车沟角度、股骨外侧滑车倾斜角、ISR及胫骨结节股骨滑车沟距离(TT-TG)共6个指标.采用Mann-Whitney U检验或独立样本t检验分别比较各测量指标在病例组和对照组间的差异性,以及各指标在同一组内不同性别以及年龄上的差异性,并计算各指标的受试者工作特征曲线下面积(AUC),确定其诊断界值及相应的灵敏度与特异度.结果:复发性髌骨不稳患者的髌骨偏移指数、髌骨倾斜角、滑车沟角度、ISR及TT-TG距离较健康人群均显著增大,而股骨外侧滑车倾斜角显著减小,且各指标相应的AUC均＞0.9.其中:髌骨偏移指数、髌骨倾斜角和ISR的诊断阈值在女性中较男性分别高出13.8％、3.1°及0.03(P＜0.05);而TT-TG距离的诊断阈值在＞16岁成人中较≤16岁青少年儿童高出2.1mm(P＜0.05).结论:伸膝时,MR定量测量的髌股关节指标对复发性髌骨不稳具有较好的临床诊断价值,且部分指标具有特异性的性别或年龄的诊断阈值:髌骨偏移指数、髌骨倾斜角和ISR的诊断界值在女性中明显高于男性,而TTTG距离的诊断界值在＞16岁成人中明显高于≤16岁青少年儿童,即TT TG距离随着骨骼发育的成熟而增加.     

髌骨运动轨迹测量方法及结果的相关研究进展

目的:总结对比测量不同人群的髌骨轨迹时所使用的参考系、对象、方法及结果,探索对髌骨轨迹的测量可否作为髌股关节疾病的诊断参数之一。方法:以patellar tracking,measurement of patellartracking,patellar mal-tracking,髌骨运动轨迹、髌骨运动轨迹的测量、膝关节紊乱、膝关节不稳定及髌骨轨迹、髌骨脱位作为关键词,在Pub Med、EMBASE databases、Medline、Psych INFO、AMED数据库进行检索。纳入英文或中文文献,研究中至少包含一种髌骨轨迹测量方法。分析髌骨轨迹测量的坐标系、研究对象、精确度、方法、结果。结果:髌骨轨迹的测量对象及方式呈多样化。使用连续的、六自由度测量方法可更加全面地记录髌骨运动轨迹,但多数研究着重于对内外侧位移、内外侧倾斜这两个自由度的静态描述。通过对髌骨轨迹在体、无创、六自由度的评估,可以更全面地反映其运动轨迹,而临床工作中仍缺乏对髌骨轨迹动态、定量的评估方式。精准、定量的髌骨轨迹测量可为临床工作者提供关于患者膝关节稳定性的全面评价。髌骨轨迹的测量或可成为一种诊断髌股关节疾病的新方法。     

320层螺旋CT 4D动态重建在髌骨脱位半脱位诊断中的初步应用

目的:探讨320层螺旋CT 4D动态重建在髌骨脱位半脱位诊断中的价值。方法:将24例髌骨脱位半脱位可疑病例,行动态扫描重建,测量诊断指标,然后统计分析数据。结果:在4个指标中,诊断髌骨脱位半脱位最有价值的是髌股吻合角与髌骨倾斜角,最有价值的角度是30°。结论:320层螺旋CT 4D动态重建在髌骨脱位半脱位病变诊断中具有独特的价值,可以多角度对髌骨的相对位置进行评价,消除某些角度产生的假阳性与假阴性,减少误诊率与漏诊率。     

Imaging of patellofemoral disorders

Anterior knee pain is a common symptom, which may have a large variety of causes including patellofemoral pathologies. Patellofemoral maltracking refers to dynamic abnormality of patellofemoral alignment and has been measured using plain film, computed tomography (CT) and magnetic resonance imaging (MRI) using static and kinematic techniques. Patellar dislocation is usually transient, but specific conventional radiographic and MRI features may provide evidence of prior acute or chronic dislocation. In addition, chondromalacia patellae, osteochondritis dissecans, patellofemoral osteoarthritis, excessive lateral pressure syndrome, and bipartite patella have all been implicated in causing patellofemoral pain. The imaging and clinical features of these processes are reviewed, highlighting the specific diagnostic features of each condition.     

髌骨轴位X线检查辅助装置的设计与临床应用

目的:设计一套髌骨轴位X线检查辅助装置,以满足膝关节不同程度屈曲受限患者髌骨轴位X线摄影及其临床应用价值.方法:髌骨轴位辅助装置制作材料均使用不锈钢材质,由膝部定位组件和探测器支撑组件两部分组成.本研究纳入100例膝关节髌股关节炎患者,膝关节均有不同程度屈曲受限,使用辅助装置进行髌骨轴位摄影,由2名擅长骨关节影像诊断的高年资影像医师观察髌骨轴位图像,并对其主要解剖结构显示能力及图像质量进行评价.结果:使用髌骨轴位辅助装置首次摄影成功率为98％,优级片率为93％,图像质量符合诊断要求;能够在膝关节屈曲不同角度(15°～90°)下拍摄髌骨轴位,并清晰显示髌骨运行轨迹情况以及准确测量髌骨沟角、适合角等相关参数.结论:使用髌骨轴位X线检查辅助装置简单、易行、摄影成功率高,图像质量符合影像诊断学要求.对于髌股关节炎、髌骨习惯性脱位、髌骨骨折的诊断有一定的临床价值.     

Results in the treatment of recurrent dislocation of the patella after 30 years' follow-up

The authors compare the clinical and radiographic outcome in patients with comparable bilateral recurrent patellar dislocation treated surgically on only one side, to clarify the appropriateness of the surgical indication. Sixteen patients were evaluated at an average follow-up of 30 years (20–45); all had been treated by the Roux technique. The results on both the operated and the unoperated knee were evaluated; the Crosby and Insall schedule was used for the clinical evaluation. Anteroposterior, lateral, and Merchant's view X-rays were examined for osteoarthritis and to measure the height of the patella. The congruence angle and the distance between anterior tibial tuberosity and trochlear groove (ATT-TG) were measured by computed tomography. The results in the operated knees were: 3 excellent, 9 good, 1 fair, and 3 worse; results in the nonoperated knees were 6 excellent, 8 good, 1 fair, and 1 worse. In the operated knees arthritis was grossly marked in 8, marked in 3, moderate in 1, and light in 4; in the nonoperated ones it was grossly marked in 8, moderate in 3, and light in 5. The congruence angle was normal in 10, medially displaced in 3, and laterally displaced in 3 cases on the operated side; on the nonoperated side it was normal in 7 cases and lateralized in the remaining 9. The ATT-TG in the operated knees was negative in 9 cases, normal in 1, and positive in 6; on the nonoperated side it was positive or normal. In 7 operated cases a low patella was documented. The Roux technique yields positive results in the correction of recurrent dislocation. No clinical or radiographic differences were found between surgically and conservatively treated knees. The clinical results are generally not comparable with the radiographic features or with severity of degenerative modifications presented at long-term follow-up. The absence of a difference is due basically to the complete lack of adaptation of the surgical procedure to the variable pathogenesis of this disorder.     

Computed tomography of the normal patellofemoral joint

Radiographic assessment of the patellofemoral joint (PFJ) is problematic because conventional views are cumbersome, difficult to standardize, and not reliable for displaying this joint with flexion of the knee less than about 30 degrees. We used computed tomography (CT) to obtain conveniently a direct transaxial view of the PFJ in ten normal human volunteers at different 0 degree, 20 degrees, and 45 degrees of knee flexion and during both contraction and relaxation of the quadriceps muscle. From the CT images we measured femoral trochlear angle, patellar centralization, femoral trochlear depth, and patella tilt angle. In full extension, with the quadriceps muscle relaxed, 19 of 20 knees showed the patella well centered in the femoral trochlear groove. The tilt and centralization of the patella were largely unchanged at 20 and 45 degrees of knee flexion with quadriceps contraction. CT appears to be an optimal method of studying the PFJ. The normal relationships described in this report can be the basis for evaluating patients with known or suspicious history of recurrent subluxation or dislocation of the patella.     

Femorotibial rotation and the Q-angle related to the dislocating patella

PURPOSE: To compare the femorotibial rotation, the patellar translation, the hip-knee-ankle angle and the Q-angle in patients with a dislocation of the patella with those of healthy volunteers. Further, the clinically measured Q-angle was compared to that measured by radiography. MATERIAL AND METHODS: A system for measurement of patellar variables was previously developed and applied to 80 healthy volunteers. In the present study, 28 patients (20 women, 8 men) with dislocation of the patella were examined bilaterally. Fourteen patients had habitual dislocations (20 affected knees) and 14 patients traumatic dislocations (17 affected knees). In 20 patients the clinical Q-angle was measured bilaterally by an orthopaedic surgeon and in 9 of these patients also by a second independent orthopaedic surgeon. RESULTS: The most striking finding was that dislocating knees in both groups showed a smaller Q-angle than the healthy knees. Further, the habitual group showed greater relative rotation between the tibia and the femur and an increased patellar translation compared to the traumatic group and to the healthy volunteers. There was a poor correlation between clinical and radiographic measurements of the Q-angle and no correlation was found between two independent clinical measurements. CONCLUSION: Surgical operations aiming at decreasing the Q-angle should be challenged.     

Cartilage lesions of the patella in recurrent patellar dislocation

BACKGROUND: The etiology of patellar cartilage lesions in recurrent patellar dislocation has been poorly understood. HYPOTHESIS: The pathology of cartilage lesions of the patella accompanied by recurrent patellar dislocation can be analyzed. STUDY DESIGN: Series of case reports. METHODS: In 70 knees from 57 patients with recurrent patellar dislocation, the cartilage lesions of the patella were examined using arthroscopy and/or macroscopic observation. The average age of the patients was 22 years (range, 13 to 40 years). Lesions that involved only softening were not included. RESULTS: Sixty-seven knees (96%) had articular cartilage lesions of the patella, and only 3 knees had no change. Fissuring was observed in 53 knees (76%). The most common site of fissuring was on the central dome. There were basically two types of fissuring: multiple longitudinal fissuring and marginal/radial fissuring. Fibrillation and/or erosion were observed in 54 knees (77%). Of these, 40 knees had fissuring and 14 did not have fissuring. The main site of fibrillation and/or erosion was the medial facet. CONCLUSIONS: Cartilage lesions of the patella in recurrent patellar dislocation cases were very common. Fissuring was observed mainly on the central dome, and fibrillation and/or erosion were observed mainly on the medial facet.     

改良Hauser术后髌股关节软骨的变化

目的:通过再次关节镜检查,了解改良Hauser手术后髌股关节软骨的变化。方法:2004年4月至2008年7月,36例髌骨脱位患者在我所进行了改良Hauser髌骨脱位矫正术,并因取金属内固定物进行了二次关节镜检查。分别评估两次关节镜检查时髌骨内侧、外侧,滑车内侧与外侧的软骨损伤情况。结果:(1)36例患者初次手术时共发现52处软骨损伤,再次关节镜检查时共发现78处软骨损伤。(2)初次及再次手术时的软骨损伤程度以2～3度为主,再次手术时增加的软骨损伤绝大部分为2度,占所有增加软骨损伤的90%。(3)初次手术时有32处髌骨软骨损伤,其中30处位于髌骨内侧,2处位于髌骨外侧面,有20处滑车软骨损伤,都位于滑车外侧面。再次手术时有28处位于髌骨内侧,16处位于髌骨外侧,14处位于滑车内侧,20处位于滑车外侧。再次手术时髌骨内侧与滑车外侧软骨损伤无明显增加,髌骨外侧及滑车内侧的软骨损伤有明显增加。结论:改良Hauser手术后髌股关节软骨损伤有一定增加,以滑车内侧及髌骨外侧的软骨损伤增加为主,增加的软骨损伤多为2度。     

50例运动员髌骨软骨病分析—临床、病理及放射学回顾性研究

本文对北京医科大学运动医学研究所13年间(1975.2—1987.9)经手术治疗的50例髌骨软骨病患者的临床资料及X片做回顾性研究,全部病人均手术证实为髌骨软骨病,为连续性资料。测量了34个膝关节的60°髌骨切线位片的5组指标并对髌骨分型。以期于临床及运动员选材提供参考。     

多层螺旋CT及曲面重建在颌骨疾病中的应用

目的：通过对24例颌骨疾病的曲面重建图像分析，探讨多层螺旋CT(MSCT)及曲面重建在颌骨疾病中的应用价值。方法：使用MSCT对颌骨进行1.25mm／4i薄层扫描，扫描范围自颞颌关节至下颌骨，将原始轴位图像用曲面重建软件(panorex display)重建成平行于颌弓的曲面断层图像和垂直于颌弓的矢状断面图像。结果：12例颌骨骨折都完整地显示出骨折的部位、类型及与上颌窦、牙槽骨的关系以及颞颌关节脱位情况。明确了舍牙囊肿，龋齿，根尖脓肿等病变的部位、病灶大小，及病变对上颌窦和牙槽骨的浸润程度。结论：多层面螺旋CT由于扫描速度快，时间短，因而减少了移动伪影，提高了图像质量。曲面重建能充分显示颌骨病变的全貌，展现每颗牙齿与牙槽骨、上颌窦、鼻腔底、切牙管与下颌管的关系和测量，给牙科治疗、手术及种植提供帮助。