16层CT重组技术在胫骨平台骨折诊断中的应用

目的探讨16层CT重组技术在胫骨平台骨折诊断中的应用价值。方法对65例常规X线平片或临床诊断为胫骨平台骨折的患者进行16层CT扫描,并对图像进行多平面重组(MPR)、容积重组(VR)和最大密度投影重组(MIP),对骨折的部位、范围、碎骨片的数量或骨折程度、胫骨平台受累情况、手术入路、骨质疏松程度及骨组织的缺损等做出评价。结果 65例胫骨平台骨折的CT图像经MPR、VR、MIP重组后,骨折显示与术中所见吻合率为100%,X线平片漏诊7例。MPR能够显示骨折的细微结构,有助于骨折类型的判断。VR、MIP重组可清晰显示骨折的立体外观、关节面碎裂及塌陷的范围。结论 16层CT重组技术能直观、多方位、立体地显示胫骨平台骨折的部位、形态、类型,关节面碎裂及塌陷程度等空间信息,对选择适当的手术方式、准确的复位和内固定具有重要的参考价值。

Application of Reconstruction with 16-slice CT in Diagnosis of Tibial Plateau Frac tures

Objective To evaluate the value of 16-slice CT reconstruction in diagnosis of tibial plateau fractures.Methods Sixty-five patients with a plain film or clinical diagnosis of tibial plateau fracture were studied with 16-slice CT.The CT images were reformed with multi-planar reconstruction(MPR),volume rendering technology(VR) and maximum intensity projection(MIP) technique.The following CT parameterswere used:fracture location and size,number of fragments or degree of depression of fracture;plateau area involved;surgical access;degree of osteoporosis and bone tissue loss.Results After MPR,VR and MIP reconstruction with 16-slice CT,all 65 patients of tibial plateau were absolutely accorded with operation findings,7 cases was omitted by X-ray.MPR is able to show interior fine situation of fractures and helpful for the classification of fractures.VR,MIP reconstruction can clearly display stereo anatomy of fracture,broken articular surface and scope of collapse of the plateau.Conclusion 16-slice CT reconstruction techniques can provide an advantage of showing the location,shape,patten,and degree of tibial plateau fractures more directly,stereoscopically and dimensionally.These techniques have an important value for surgeons to choose therapeutic,reduction and fixed method and surgical approach.