MSCT重建图像在桡骨远端骨折分型中的应用

目的 探讨多层螺旋CT(MSCT)图像重建在桡骨远端骨折分型评价中的应用价值。方法 选择64例桡骨远端骨折患者, 均拍摄腕关节正侧位X线平片, 并行MSCT扫描。X线和CT图像均通过PACS局域网传送至工作站, 由一位副主任医师根据X线正侧位片, 以及CT原始图像和后处理重建图像(包括多层面重组、容积成像等)分别独立进行骨折诊断, 并按AO系统分型。结果 64例患者经X线平片检查, 8例漏诊, 56例诊断骨折, 包括A型23例, B型17例, C型16例。MSCT扫描及后处理图像的64例均发现骨折, 包括A型15例, B型25例, C型24例。两种检查方式对桡骨远端骨折分型差异有统计学意义(P<0.05)。结论 MSCT检查及后处理重建图像对桡骨远端骨折诊断和分型更为准确和详细, 尤其对复杂性关节内骨折的评价具有重要的临床价值。

Application of Multislice Computed Tomography Image Reconstruction in Evaluating the Classification of Distal Radius Fracture

Objective To investigate the clinical application of multislice computed tomography(MSCT) image reconstruction in evaluating the classification of distal radius fracture. Methods A total of 64 patients with distal radius fracture were imaged with both conventional X-ray and MSCT. All the images were transmitted to the work station through picture archiving and communication system(PACS) and were independently judged and classified with AO classification system by one associate chief physician, according to the X-ray and MSCT scans and its image reconstruction(multiplanar reconstructions, volume rendering and so on). Results In the 64 patients, 8 patients were not visualied and 56 patients were diagnosed as distal radius fracture on conventional X-rays including 23 patients of type A, 17 of type B and 16 of type C. All the 64 patients were diagnosed fracture with MSCT scans and reconstruction including 15 cases of type A, 24 of type B and 23 of type C. There was statistical difference between the two technologies in evaluating the classification of distal radius fracture. Conclusion It is more accurate and specific in asessing the diagnosis and classfication of distal radius fracture using MSCT-scan and image reconstruction, especially for complex intra-articular fracture with significant clinical application, compared with conventional X-ray.