双层螺旋CT三维重建在骨关节创伤的应用价值

目的 评价双层螺旋CT三维重建在骨关节创伤的临床应用价值.方法 10例志愿者和30例骨关节创伤患者用SIEMENS SOMATOMEmotion Duo CT进行螺旋扫描和图像三维重建,并与X线平片进行对照.志愿者用不同的层宽、准直宽度、重建增量和算法进行扫描和图像处理,分析影响三维重建图像质量的因素.结果 准直宽度1.0～2.5 mm、层宽1～3mm、重建增量1～2 mm、高锐利度算法可获得清晰、平滑的MPR图像,用平滑算法重建的SSD图像较高锐度算法重建的图像平滑、细腻.本组30例患者,螺旋CT三维重建诊断骨折的准确率为100%,X线平片为86.7%.螺旋CT三维重建图像可清楚显示复杂骨折的细节和碎骨片的空间位置关系,且能发现X线平片漏诊的多处骨折.结论 双层螺旋CT结合三维重建是评价复杂骨折的一个有效工具,特别是诊断不规则骨的骨折和脱位是一个非常有用的方法.

Value of three-dimensional dual-slice helical CT in diagnosing trauma in bone and joint

Objective To evaluate three-dimensional dual-slice helical CT in diagnos-ing trauma in bone and joint.Methods 10 volunteers and 30 patients underwent SIEMENS SOMATOM Emotion Duo helical CT imaging and three-dimensional reconstruction.CT images were later compared with X-ray films.Volunteers were exam-ined with different collimation,slice width,increment and algorithms in order to probe factors that influence imaging quality.Results Clear and smooth MPR images were obtained at parameters 1mm-2.5mm collimation,1mm-3mm slice width,1mm-2mm in-crement and high-resolution algorithms.Smooth algorithms can get smoother and finer SSD images than high-resolution algorithms.The accuracy of diagnosis was 100% for three-dimensional helical CT imaging superior to X-ray plain film(86.7%).Helical computed tomography is able to display details of compound fractures and stereo location of bone debris,and able to detect fractures that had been omitted by X-ray plain films.Conclusion Dual-slice helical computed tomography in combination with 3D reconstruction is an effective tool for diagnosing complex fracture,especially for frac-tures and dislocations in irregular bones.