16-MSCT对颞骨微细或隐匿性骨折的价值研究

目的:探讨16层螺旋CT(16-MSCT)对外伤性颞骨微细或隐匿性骨折(MOF)的诊断价值。方法:随访常规头颅CT检查诊断有可疑颞骨MOF者,于复查时常规5mm层厚螺旋扫描后进行0.625mm、1.25mm、2.5mm及5mm高分辨率骨算法重建(以下简称骨重建),采集数据完整者314例,结合二维及三维图像进行阅片,按不同层厚计算MOF的显示分值及显示率,进行自身对照。结果:314例均查出有颞骨MOF,每例1～27处不等。分组比较MOF的显示率:①0.625mm层厚的显示率为100%;②1.25mm层厚的显示率为87.62%;③2.5mm层厚的显示率为57%;④5mm层厚的显示率为39.22%;以上分组比较经统计学(趋势卡方检验)分析,差异均有统计学意义(P<0.05);可认为扫描层厚与显示效果间存在线性趋势,即层厚越薄显示效果越好。结论:16-MSCT趋于各向同性,在本文研究范围内重建层厚越薄MOF显示越清楚。对可疑颞骨MOF的病例应常规做0.625mm高分辨率骨算法重建,这样有利于减少漏诊率、提高诊疗水平,值得推广。

Study of 16-MDCT Thin-section Reconstruction Technology in Patients with Temporal Bones Micro- or Occult- fracture

Purpose: To evaluate the value of 16-MSCT in diagnosis of traumatic temporal bone micro-or occult-fracture(MOF).Methods: Patients with suspected temporal bone MOF were followed,and 314 cases were completed.Conventional 5mm thin-section helical CT scannings with 0.625mm、1.25mm、2.5mm and 5mm high resolution bone algorithm reconstructions were undergone in the follow-up exam for these patients.The two-dimensional and three-dimensional images were combined to interpret the temporal bone MOF.The detection rate of MOF was calculated and compared for the different thin-section thickness reconstructions.Results: All 314 cases were shown with MOF,and each case was with 1~27 different locations of MOF.The detective rate of MOF in different groups was:100% for the 0.625mm thin-section reconstruction;87.62% for the 1.25mm;57% for the 2.5mm;and 39.22% for the 5mm.The above grouping comparison was analyzed by tendency χ2-test,the differences between the different thickness reconstruction groups were shown with statistical significance(P<0.05).Conclusion: By using 16-MSCT,the thinner the sections are reconstructed,the clearer of MOF will be displayed.For the patients with suspected temporal bone MOF,0.625mm high resolution bone algorithm reconstruction should be used.It is useful to reduce the miss-diagnosis rate.