多层螺旋CT不同重建方法在骨关节创伤中的应用价值比较

目的 比较多层螺旋CT(MSCT)不同重建方法在骨关节创伤中的应用价值。资料与方法 51例创伤患者，全部行伤患处薄层螺旋CT横断面扫描及MPR、VR、SSD重建，分析比较几种方法重建图像对各部位骨折或脱位的显示效果。结果 颅面骨创伤3例，颈椎6例，肩关节6例，肘关节5例，膝关节10例，踝关节9例，骨盆12例。横断面扫描显示出骨折及脱位50例(98．0％)，SSD重建明确诊断47例(92．2％)，VR重建明确诊断49例(96．1％)，MPR重建均获明确诊断。图像显示横断面扫描可发现细小骨折但缺乏立体信息，3D重建立体感强，可多角度、多方位观察，骨折移位及关节脱位情况一目了然；MPR法显示骨折线的走行和移位更有优势且能兼顾软组织改变。结论 MSCT几种重建方法各有优势，应以横断面扫描信息为基础，根据部位及伤情结合以MPR、SSD、VR中的一种或几种，为临床诊治及随访提供全面、精确而直观的信息。

Evaluation of Multi-slice Spiral CT in Diagnosing Trauma of Bones and Joints: A Comparison between Different Reconstructions

Objective To discuss the advantages and disadvantages of different reconstruction techniques of multi-slice CT (MSCT) in diagnosing trauma of bones and joints.Materials and Methods MSCT scanning with SSD, VR and MPR reconstruction was performed in 51 patients with traumatic fracture or dislocation. The image qualities were compared between different reconstructions.Results The trauma included maxillofacial fracture (n=3), cervical spine (n=6) shoulder (n=6), elbow (n=5), knee (n=10), ankle (n=9) and pelvis (n=12). Axial images displayed the fracture or dislocation in 50 cases (98.0%), of which SSD and VR confirmed 47 (92.2%) and 49 (96.1%), respectively. MPR demonstrated all traumas. MSCT could show, although less stereoscopically, tiny fractures, while 3D images, including SSD and VR, could stereoscopically display the fracture and dislocation. MPR was superior to other techniques in comprehensively displaying the course of fracture line together with soft tissue changes.Conclusion Each reconstruction of MSCT has its own advantages and disadvantages in displaying traumatic fracture and dislocation. Based on the traumatic site and severity, a combination of conventional axial scans with one of MPR, SSD or VR can provide complete and precise information useful for clinical management.