颌面部骨折螺旋CT二维和三维重建的诊断价值

目的:探讨多层螺旋CT三维重建在颌面部骨折诊断中的应用价值。方法:回顾性分析2005年10月—2009年6月在我院行多层螺旋CT扫描并诊断为颌面骨骨折的影像学资料32例,采用多层螺旋CT扫描和三维重建方法:扫描层厚1mm,方法为多平面重组法(MPR)、表面阴影显示法(SSD)和容积再现法(VR),术后将二维和三维图像与手术所见进行回顾性对照分析和验证。结果:32例颌面骨骨折,螺旋CT二维、三维图像可以全部显示颧骨骨折、上、下颌骨骨折和鼻骨骨折,但在显示骨折线行程和骨折块移位上三维图像优于二维图像;二维横断位图像全部显示筛骨、蝶骨和腭骨骨折,而三维图像部分不能显示,效果明显不如二维图像。结论:二维图像仍是诊断颌面骨骨折最基本的手段,三维重建图像的优势在于可以显示颌面骨骨折线和骨折片移位的空间解剖关系,在指导手术设计、提高手术疗效方面具有重要的临床应用价值。

The Diagnostic Value of Multi-slice CT three Dimensional Reconstruction in Maxillofacial Fracture

Objective：To evaluate the diagnostic and clinical value of spiral CT three dimensional reconstruction for maxillofacial fracture. Methods：32 cases with maxillofacial fracture,The spiral CT scan with slice thickness of lmm, the methods of three dimensional reconstruction include ：multi-planar reformation （MPR）,shaded surface display （SSD）.To retrospect analyse 3D imaging related with operation.Results：A total 32 cases maxillofacial fracture were showed by 2D or 3D imaging and were validated by operation. The spiral CT with 3D reconstruction imaging were superior significantly to 2D axial imaging in maxillofacial fracture. 3D imaging can clear show the space relationships of facial, fragment displacement and tracing fracture lines.Conclusion ：3D images have important value for diagnosis and clinical in assessing maxiIIofacial fracture, It can provide space relationship information and panorama of the maxillofacial fracture. 2D images can provide detail and soft-tissue changes of the maxillofacial fracture, It is basis of＇instrument in diagnosis of the maxillofacial fracture. It is best imaging methods that 2D imaging combine with 3D imaging for maxillofacial fracture.