多层螺旋CT及重建技术在胸部创伤中的临床应用

目的:讨论多层螺旋CT(MSCT)扫描及重建技术在胸部创伤中的临床应用价值。方法:57例胸部创伤病人行MSCT扫描,重建层厚2.5 mm,间隔1.25 mm,将数据传至专门工作站,对骨性胸廓进行多平面重建(MPR)、薄层最大密度投影(STS-MIP)及容积再现(VR)重建,对横断面图像及重建图像进行回顾性分析。结果:57例胸部创伤患者中,发现肺挫伤44例,肺撕裂伤4例,肺不张及肺萎缩11例,气胸27例,胸腔积液42例,肋骨骨折36例,肋软骨骨折2例,肩胛骨骨折6例,锁骨骨折3例,胸椎骨折1例。MPR图像可清楚显示骨折线的走行及移位,3D重建图像从各个方位显示了骨折的空间改变。结论:多层螺旋CT扫描能够清晰显示肺部损伤情况,胸廓重建图像可以显示骨折的立体空间改变,两者相结合,对临床制定治疗方案具有重要的参考价值。

Clinical application of MSCT and reconstruction technique in chest trauma

Objective:To discuss the clinical value of MSCT and reconstruction technique in chest trauma.Methods:Fifty-seven patients were performed MSCT scan of chest,reconstructed slice thickness 2.5mm,slice increment 1.25mm.The data were transferred to the workstation and post-processed with multiple planar reformatting(MPR),sliding thin-slab maximum intensity projection(STS-MIP)and volume rendering(VR).All images were analyzed retrospectively.Results:In fifty-seven cases,CT scans showed contusion of the lung(n=44),laceration(n=4),traumatic atelectasis and atrophy(n=11),pneumothorax(n=27),pleural effusion(n=42),costal bone fracture(n=36),costal cartilage fracture(n=2),scapula fracture(n=6),clavicle fracture(n=3),thoracic spine fracture(n=1).MPR was superior in displaying alignment and displacement of fracture.Three-dimensional reconstruction was accurate in displaying the space change of bone structures from any arbitary direction.Conclusion:MSCT scans can clearly demonstrate the injuries of lung.MPR and three-dimensional reconstruction can show the space change of bone structures.The combination of MSCT scans and reconstruction technique plays an important role in clinical treatment.