多层螺旋CT三维重建技术在骨盆骨折脱位中的应用

目的探讨CT三维重建在骨盆骨折脱位诊治中的应用价值。方法37例骨盆骨折脱位患者，术前均行X线、GE Light speed 16CT扫描和CT三维重建成像。其中使用CT三维重建成像技术做骨盆图像任意角度旋转，获得骨盆各个方位的图像，并根据需要摄片。结果37例CT三维重建成像均能较清晰显示骨盆骨折、脱位在三维层面即矢状面、额状面及水平面上的移位方向和程度，以及骨盆变形和损坏情况。临床根据骨折脱位和损坏的程度，选择了恰当的治疗方案和手术入路，其中26例行切开复位重建钢板螺钉内固定术，11例采取保守疗法。术后26例随访1—1．5年，平均16个月。依据Matta评分标准：优18例，良6例，尚可2例。结论CT三维重建获得三维空间图像，能直观、全面、精确地显示骨盆的立体形态和各部位解剖结构的空间关系，为临床选择手术入路和治疗方案有指导作用。

Application of Three-Dimensional CT Reconstruction in Diagnosis and Treatment of Pelvic Fracturedislocation

Objective To study the application value of three-dimensional CT （3-DCT） reconstruction in diagnosis and treatment of pelvic fracture-dislocation. Methods Thirty-seven patients suffered from pelvic fracturedislocation were examined with X-ray, CT and 3-DCT before operation. Further more we used the 3-DCT to obtain the overall images of pelvic and take the photographs needed by rotating at any angle. Optimal treatment and surgical approach were adopted based on the state of pelvic fracture-dislocation and the damage extent of pelvic ring in 3-DCT images. Among them, Twenty-six cases were treated with open reduction and internal fixation, and 11 cases received non-operative treatment. Results Direction and degree of fracturedislocation, damage extent of pelvic ring were showed through 3-DCT in all the cases. Twenty-six cases were followed up from 12 to 18 months with average of 16 months. According to fracture healing criterion,excellent in 18 cases,good in 6 and fair in 2. Conclusion 3-DCT reconstruction can display pelvic three-dimensional form and spatial relationship of all anotomic structure,play an important role in selection of operative approach and internal fixation.