眼眶爆裂性骨折二维及三维CT图像分析及其临床意义

目的 初步探讨和评价CT两维、三维成像技术（2D-CT,3D-CT）对眼眶爆裂性骨折修复术的临床指导作用.方法 以2D-CT及3D-CT成像技术诊断眶壁骨折资料为依据,以Medpor人工骨片及羟基磷灰石人工骨片为填充材料,对39例（39眼）眼眶爆裂性骨折施行眶壁骨折修复术.结果 2D-CT良好的显示出眶内软组织嵌顿及疝出的状态,3D-CT清晰的显示出眶壁骨折空间立体结构,窦腔重建图像具有帮助术前诊断和了解窦损伤情况的作用.37例眼球内陷经3月的术后观察,33例完全矫正,4例部分矫正;34例复视者中30例复视症状基本消失.结论 CT两维、三维成像相结合有助于医生精确的进行手术设计,较好地解决眼球内陷、复视和美容问题.

Important of two and three-dimensional CT reconstruction in orbital blowout fracture

Objective To explore the importantce two-dimensions and three-dimensional CT reconstruction in surgical treatment for orbital blow-out fracture.Methods According to two-dimensional and three-dimensional imaging,MEDPOR orbital implants and HA as orbital grafting material were used.Reconstruction of the orbit and reposition of the globe perfomed on 39 patients with orbital blow-out fracture.Postoperatively,they were followed up for average of 3 months. Results Two-dimensional imaging was very clear in showing soft tissue herniation and soft tissue entrapment.MPR and 3D-CT was clear in showing the stereo conformation of orbit.In the 39 cases with enophthalmos of orbital blow-out fracture,three months after operation,the measurements demonstrated that 33 patients had no enophthalmos,4 cases had mild enophthalmos(1-2 mm).34 of 39 patients had diplopia preoperatively,30 patients had satisfactory results. Conclusions Two and three-dimensional CT reconstruction provides satisfactory understanding of the orbital fracture,it permits a more specific preoperative analysis and surgical planning and they are the ideal guides during the operation.