螺旋CT扫描及多平面重建(MPR)技术在骶尾部病变诊断中的应用

目的探讨螺旋CT扫描及多平面重建(MPR)技术在骶尾部病变诊断中的应用价值。方法将2014年5月-2016年4月因骶尾部疼痛入院就诊的64例患者作为研究对象,均拍摄骶尾骨正侧位DR片和螺旋CT骶尾部扫描,采用MPR技术对CT图像进行重建。结果正侧位DR片显示54例无骨质异常,10例疑似骨折;经螺旋CT及MPR技术重建后,2例疑似骨折,14例骨折,8例肿瘤,1例发育异常。16例骨折或疑似骨折患者中,12例骶骨部周围软组织肿胀,6例有明显骨折线。8例骶尾部肿瘤(经临床病理证实),5例骶骨脊索瘤,骶骨溶骨性破坏,有分叶状软组织肿块,部分周围脏器受压,瘤体内有钙化点;3例巨细胞瘤,骶骨骨质呈皂泡样破坏,周围有软组织肿块,边界清晰,周围结构有推移,与周围正常骨质移行带变窄;1例骶骨神经纤维瘤,相应骶孔扩大,骶前组织肿块,边界清晰。1例发育异常可见骶骨部透亮带。结论螺旋CT扫描及多平面重建MPR技术可为临床诊治骶尾部病变提供丰富信息。

Application of Spiral CT Scan and Multi Planar Reconstruction Technique in the Diagnosis of Sacrococcygeal Diseases

Objective To explore the application value of spiral CT scan and multi-planar reconstruction (MPR) technique in the diagnosis of sacrococcygeal diseases. Methods 64 cases of patients with sacrococcygeal pain who were admitted into our hospital between April 2013 and April 2015 were enrolled in the study. The positive side and left-right oblique position DR films of sacrococcyx of all patients were took and all patients underwent spiral CT scanning of sacrococcyx. The CT images were reconstructed by MPR technique.Results The positive side and left-right oblique position DR films showed that there were no bone abnormalities in 54 cases, and 10 cases with suspected fractures; After spiral CT and MPR technique, there were 2 cases with suspected fractures, 14 cases with fractures, 8 cases with tumors and 1 case with abnormal development. Among 16 cases of patients with fractures or suspected fractures, there were 12 cases with soft tissue swelling around sacrum and 6 cases with obvious fracture line. 8 cases had sacrococcygeal tumors (confirmed by clinical pathology). 5 cases had sacral chordoma, sacral osteolytic destruction, lobulated soft tissue masses, localized surrounding organs compression and calcification in tumors. 3 cases had giant cell tumors, and the sacral bone showed soap bubble-like destruction, surrounded by soft tissue masses, with clear boundaries, shift of the surrounding structures, and the surrounding normal bone transition zone narrowing; 1 case had sacral neurofibroma, with enlargement of corresponding sacral foramen, with anterior sacral tumor with clear boundary. 1 cases of abnormal sacral development showed radiolucent zone.Conclusion Spiral CT scan and MPR technique can provide abundant information for clinical diagnosis and treatment of sacrococcygeal lesions.