MSCT在腕关节外伤中的应用

目的:探讨MSCT在腕关节外伤中的应用价值。方法:连续收集本科室2008年1月~12月因外伤进行腕关节MSCT检查的病例共计34例。MSCT扫描采用16层螺旋CT扫描仪(Siemens Somatom Sensation 16)。扫描及重建参数:120kV,120mAs,准直器宽度0.75mm,螺距0.55,1.0mm重建层厚、0.5mm重建间距,采用高分辨骨算法重建。重建的薄层图像传至Siemens多功能后处理工作站(MMWP)进行图像后处理。评价各种后处理技术对腕关节外伤的诊断价值。结果:在34例腕关节外伤中,共发现骨折40处。以舟状骨的骨折最多见,共计14处,月骨骨折3处,三角骨骨折3处,大多角骨骨折2处,小多角骨骨折1处,头骨骨折1处,钩骨骨折2处,尺桡骨远端骨折7处,掌骨基底部骨折7处。上述部分骨折伴有月骨脱位、月骨周围脱位等。薄层多平面重组(MPR)图像能清晰显示细微的骨折和骨折脱位的方向;曲面重组(CPR)图像可以在一幅图像上显示不同平面的结构和骨折;容积重建(VR)图像可以清晰显示复杂骨折脱位时各腕骨间的空间关系。结论:MSCT的各种重建和重组技术能清晰显示腕关节外伤的各种骨折和脱位,在腕关节外伤的临床诊断中有较大应用价值。

MSCT in diagnosing of traumatic wrist

Objective：To evaluate the value of MSCT in diagnosing of traumatic wrist.Methods：34 patients with trauma of the wrist performed MSCT were studied.A 16-slice CT scanner was used（Siemens Somatom Sensation 16）.Scan and reconstruction parameters were as follows： 120 kV,120 mAs,collimator width 0.75 mm,pitch 0.55,reconstruction thickness 1.0 mm,increment 0.5 mm,high-resolution algorithm.Thin images were sent to Siemens multimodality workplace（MMWP） for reconstruction and reformation.Diagnostic value of each reconstruction and reformation technique was analyzed.Results：40 fractures were found.Among these fractures,there were 12 in scaphoid,3 in lunate,3 in trequetral,2 in trapezium,2 in hamate,7 in distal radius and distal ulna,and 7 in basis of metacarpal bone.There were fracture in trapezoid and 1 in capitate.Some cases were complicated with dislocations.Minimal fractures and orientation of dislocations presented clearly in MPR image;structures of different planes could present in one CPR image.Spatial relations among carpal bones of complicated fracture dislocations presented clearly in VR image.Conclusion：Reconstruction and reformation techniques of MSCT can show fractures and dislocations of the traumatic wrist clearly,which is valuable in diagnosing of traumatic wrist.