多层螺旋CT及其三维重建技术在高能量所致椎体爆裂性骨折患者诊治中的应用

目的探讨多层螺旋CT及其三维重建技术在高能量所致椎体爆裂性骨折患者诊治中的应用价值。方法以2012年1月-2016年1月我院收治的160例高能量所致椎体爆裂性骨折患者为研究对象,均接受多层螺旋CT横断面图像及其三维重建技术、X线片检查,比较不同检查技术对椎体爆裂性骨折检出率、骨折类型准确诊断的差异。结果多层螺旋CT及其三维重建技术共检出180个椎节爆裂骨折,多发爆裂性骨折仅11例;椎体后移骨片位置:单个中央骨片、骨片中央矢状裂开、偏向椎管一侧的骨片、粉碎性骨片的椎节各78、5 3、38、11个;后移骨片来源:椎体角者、椎体后壁者、后下角者各101、20、39例;轻、中、重度椎管狭窄者各90、60、1 0例,手术内固定有90例;检出椎板骨折共60个椎节,左侧椎板骨折、右侧椎板骨折、双侧椎板同时骨折椎节各2 5、1 0、25个。多层螺旋CT及其三维重建技术骨折椎节检出率99.45%、多发爆裂骨折、椎体脱落骨片移入椎管及轻度椎管狭窄的准确诊断率91.67%、99.45%、1 00.00%较X线平片的显著高(P0.05)。结论多层螺旋CT及其三维重建技术可有效提高高能量所致椎体爆裂性骨折的检出率及骨折损伤类型的准确诊断率,为临床实施针对性治疗措施提供重要参考。

Application of Multi-slice Spiral CT and Its 3D Reconstruction Technique in the Diagnosis and Treatment of High Energy Induced Vertebral Burst Fractures

Objective To investigate the value of multi-slice spiral CT and its three-dimensional (3D) reconstruction technique in the diagnosis and treatment of high energy induced vertebral burst fractures.Methods 160 patients with high energy induced vertebral burst fractures who were admitted to the hospital between January 2012 and January 2016 were selected as study subjects. All patients underwent multi-slice spiral CT cross-sectional images, its 3D reconstruction techniques and X-ray examination. The detection rates of different detection techniques for vertebral burst fractures and the accuracy rates in the diagnosis of fracture types were compared.Results A total of 180 vertebral burst fractures were detected by multi-slice spiral CT and 3D reconstruction techniques, involving vertebral segments T11, T12, L1, L2 and L3, and the numbers were 8, 50, 80, 32 and 10 respectively. There were 11 cases with multiple burst fractures. For the position of vertebral moving backward bone graft, it was found that the numbers of vertebral segments with single central bone graft, central sagittal fractures, bone graft deviate to one side of the spinal canal and comminuted bone graft were 78, 53, 38 and 11. For the source of moving backward bone graft, the numbers of cases from vertebral angle, posterior wall of the vertebral body and the lower corner were 101, 20 and 39. The numbers of cases with mild, moderate and severe spinal stenosis were 90, 60 and 10, and 90 cases received internal fixation. There were 60 cases with vertebral plate fractures, including left vertebral plate fractures, right vertebral plate fractures and bilateral vertebral plate fractures in 25, 10 and 25 vertebral segments. The detection rate of multi-slice spiral CT and its 3D reconstruction for vertebral fractures was 99.45%, and the accurate diagnosis rates of multiple vertebral burst fractures, bone grafts into the spinal canal and mild spinal stenosis were 91.67%, 99.45% and 100.00%, significantly higher than those of X-ray films (P<0.05).Conclusion Multi-slice spiral CT and its 3D reconstruction techniques can effectively improve the detection rate of high energy induced vertebral burst fractures and the accurate diagnosis rate of fracture types, which provides important references for implementation of targeted treatment measures.