螺旋CT在踝关节及跗骨骨折中的应用价值

目的探讨螺旋CT在踝关节及跗骨骨折中的应用价值。方法收集分析43例踝关节及跗骨骨折，所有病例均行普通x线摄影和螺旋CT薄层扫描，35例螺旋CT扫描后选择性应用表面遮盖显示（SSD）和多平面重组（MPR）等图像后处理技术进行图像重建。结果在43例骨折病例中，28例（65．1％）普通x线检查报告为阳性的病例经螺旋CT扫描又发现其他部位骨折，15例（34．9％）普通x线检查报告为阴性的病例经螺旋CT确诊为阳性；螺旋CT上骨折线表现为长度、宽度、走行及数量不同的线状低密度影，对粉碎性和撕脱性骨折病例再行SSD和MPR图像重建，进一步明确骨折线的空间走向和碎骨片的形状、大小及空间位置。结论螺旋CT薄层扫描结合图像后处理技术，在踝关节及跗骨骨折中有非常重要的应用价值。

The value of spiral CT scan on fracture of ankle joint and tarsal bones

Objective To study the value of spiral CT scan on the fracture of ankle joint and tarsal bones. Methods 43 cases with the fracture of ankle joint and tarsal bones were collected and analyzed. All the cases were examined by plain film radiography and spiral CT thin slice scan. Multi-planar reformation （MPR）, surface shaded display （SSD） and other techniques of image post-processing were performed in 35 cases of them. Results Spiral CT scan could demonstrate more fractures than plain film radiography in 28 cases（65.1%）. There are 15 cases （34.9%） which are normal in plain film radiography but abnormal in Spiral CT scan. Spiral CT could demonstrate the different length, width, direction and number of linear low density shadow. SSD and MPR were performed again in the cases with avulsion fracture and fragmental fracture to demonstrate the fracture direction and the shape, size and location of fragments more clearly. Conclusion Spiral CT thin slice scan with image post-processing techniques can play an important role in fracture of ankle joint and tarsal bones.