多排CT及重建技术检查髋臼骨折的临床应用价值

目的评价多排CT(multidetector CT,MDCT)及其多平面重建(multiplanar reformation,MPR)、容积再现(volumerendering,VR)重建技术检查髋臼骨折的临床应用价值。方法 32例接受手术治疗的髋臼骨折患者外伤后0～3 d进行MDCT薄层扫描,回顾性重建扫描数据后形成图像重建数据,用MPR、VR软件对图像重建数据进行后处理技术重建,分别得到MPR和VR图像。从髋臼骨折类型、骨碎片移位程度和髋关节腔内骨碎片3方面将MDCT原始图像、MPR和VR重建图像显示髋臼骨折的结果与手术结果进行对照分析。结果 MDCT原始图像、MPR和VR重建图像判断髋臼骨折类型的诊断符合率分别为78.13%、87.50%和100.00%,VR重建图像最高;检测骨碎片移位程度的诊断符合率分别为81.19%、100.00%和96.04%,MPR重建图像最佳;显示髋关节腔内骨碎片的诊断符合率分别为84.00%、100.00%和72.00%,MPR重建图像最好。结论 MDCT原始图像、MPR和VR重建图像检查髋臼骨折各有优缺点,三者结合能够互为补充,可靠判断髋臼骨折类型、准确检测骨碎片移位程度、全面显示髋关节腔内骨碎片,为髋臼骨折的诊断和治疗提供很有意义的影像学信息。

Clinical Application Value of Multidetector CT and its Reconstruction Techniques in Examination of Acetabular Fracture

Objective To evaluate the clinical application value of multidetector CT(MDCT) and its multiplanar reformation(MPR) and volume rendering(VR) reconstruction techniques in examination of acetabular fracture.Methods Thin-section MDCT scan was performed within 3 days after trauma in 32 patients with acetabular fracture and operation treatment.Image reconstruction data was formed after retro-reconstruction of scan data.MPR,VR images were obtained retrospectively by postprocessing of image reconstruction data with MPR,VR image processing software.The findings of MDCT initial image,MPR and VR reconstruction images were comparatively analyzed with surgical results according to fracture types,displacement degree of fragments,and fragments in hip joint cavity.Results With MDCT initial image,MPR and VR reconstruction images,the diagnosis correction rate of judging fracture types was 78.13%,87.50% and 100.00% respectively,VR reconstruction image was the best;the diagnosis correction rate of examining displacement degree of fragments was 81.19%,100.00% and 96.04% respectively,MPR reconstruction image was the best;the diagnosis correction rate of manifesting fragments in hip joint cavity was 84.00%,100.00% and 72.00% respectively,and MPR reconstruction image was the best too.Conclusion There are both advantages and disadvantages of MDCT initial image,MPR and VR reconstruction images in examination of acetabular fracture.A combination of the three can complement to each other to reliably judge fracture types,accurately examine displacement degree of fragments and comprehensively reveal fragments in hip joint cavity,providing very meaningful imaging information for diagnosis and treatment of acetabular fracture.