CT三维重建技术在骨盆骨折脱位中的应用价值

目的:探讨CT三维重建在骨盆骨折脱位诊治中的应用价值。方法:37例骨盆骨折脱位患者,术前均行X线、CT扫描和CT三维重建成像,通过骨盆像的任意旋转,获得骨盆各个方位的图像,并根据需要摄片。根据骨盆骨折脱位和骨盆环的破坏程度,选择最佳治疗方案和手术入路。其中26例行切开复位重建钢板螺钉内固定术,11例采取保守疗法。结果:37例CT三维重建成像均能较清晰显示骨盆骨折脱位在三维层面即矢状面、额状面及水平面上的移位方向、移位程度及骨盆环破坏情况。术后35例获得随访,随访时间2~4.5年,平均33个月,参照骨折疗效标准:优23例,良8例,可4例。结论:CT三维重建把CT扫描和图像重建技术有机地结合得出三维空间图像,能直观、全面、精确地显示骨盆的立体形态和各部位解剖结构的空间关系,对选择合适的手术入路和内固定起重要作用。

Application value of three-dimensional CT reconstruction in diagnosis and treatment of pelvic fracture-dislocation

Objective:To explore the application value of three-dimensional CT(3-DCT) reconstruction in diagnosis and treatment of pelvic fracture-dislocation.Methods:Thirtyseven patients of pelvic fracture-dislocation were examined with X-ray,CT and 3-DCT before operation.By random rotation,3-DCT could obtain overall image of pelvic,which could be taken photographs for need.Optimal treatment and surgical approach were adopted based on the state of pelvic fracture-dislocation and the damage extent of pelvic ring.Among them,26 cases were treated with open reduction and internal fixation,and 11 cases received nonoperative treatment.Results:Direction and degree of fracture-dislocation,damage extent of pelvic ring were showed through 3-DCT in all the cases.35 cases were followed up from 24 to 54 months with average of 33 months.According to fracture healing criterion,excellent in 23 cases,good in 8 and fair in 4.Conclusion:3-DCT reconstruction have the important role in selection of operative approach and internal fixation,which is a technical conjugation between CT and image reconstruction.It can display pelvic three-dimensional form and spatial relationship of all anatomic structure.