64层螺旋CT三维重建在复杂性颌面骨折诊断与治疗中的临床意义

目的评价64层螺旋CT三维重建在复杂性颌面部骨折诊断与治疗中的临床意义。方法50例临床疑有复杂性颌面骨折患者（28例煤矿工外伤和22例交通事故外伤）于外伤后2-23（平均121h内均经64层螺旋cT平扫和三维重建（SSO）成像。依据手术所见，对比性分析了CT平扫与三维重建像对骨折部位、伴发骨折及骨折线的显示能力。结果50例疑有颌面骨折患者中，上颌骨骨折伴颧骨、眶骨骨折26例，上颌骨骨折伴颧骨、眶骨、鼻骨、额骨骨折14例，颧骨、眶骨、鼻骨骨折6例，颧骨、眶骨骨折4例。三维重建（SSD）像清晰显示了部分患者中cT平扫未发现的横向、斜向骨折线。结论cT三维重建成像能立体地、直观地显示复杂性颌面骨折的部位及伴发骨折，尤其在显示隐匿性骨折线方面明显优于CT平扫，因此，它能为制定精细的手术方案提供可靠依据。

Clinical significance of 64-slice spiral CT with 3D reconstruction in the diagnosis and treatment of complex maxillofacial fractures

Objective To assess the clinical significance of 64-slice spiral CT with 3D reconstruction in the diagnosis and treatment of complex maxillafacial fractures （CMF）.Methods Fifty patients with clinically suspected CMF which comprised 28 coal miner＇s trauma and 22 traffic accident＇s traum underwent CT plain scan and 3D reconstruction （SSD）with a 64-slice spiral CT scanner within 2 to 720 hours （mean,361 hours） after trauma. The capability of CT plain scans and 3D reconstruction images in visualizing fracture loca- tion, accompanying fracture and fracture line was comparatively analyzed based on surgical findings. Results Among 50 cases with sus- pected CMFs, maxillary bone fractures associated with zygomatic bone and orbital bone fracture were found in 26, maxillary bone fractures associated with zygomatic bone-, orbital bone -, nasal bone-, and frontal bone fractures in 14,zygomatic bone-,orbital bone-and nasal bone fractures in 6,zygomatic bone-and orbital bone fractures in 4.CT 3D reconstruction （SSD） imaging clearly revealed transverse and oblique fracture lines not visible on CT plain scan in part patients. Conclusion CT 3D reconstruction imaging can stereoscopically and directly reveal the location and accompanying fracture of CMFs,especially in visualizing occult fracture line, it is significantly superior to CT plain scan so that it can provide reliable evidence for planning a precise surgery protocol.